Open Collections

UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

Attitude of Canadian dental hygienists toward mandatory continuing education 1980

You don't seem to have a PDF reader installed, try download the pdf

Item Metadata

Download

Media
UBC_1980_A8 F67.pdf [ 4.13MB ]
UBC_1980_A8 F67.pdf
Metadata
JSON: 1.0055940.json
JSON-LD: 1.0055940+ld.json
RDF/XML (Pretty): 1.0055940.xml
RDF/JSON: 1.0055940+rdf.json
Turtle: 1.0055940+rdf-turtle.txt
N-Triples: 1.0055940+rdf-ntriples.txt
Citation
1.0055940.ris

Full Text

c I, ATTITUDE OF CANADIAN DENTAL IIYCIENISTS TOWARD MANDATORY CONTINUING EDUCATION by MARGERY G. E. FORGAY DIP. D.H., EASTMAN DENTAL DISPENSARY, 1952 B.A., UNIVERSITY OF SASKATCHEWAN, 1955 B.Ed., UNIVERSITY OF MANITOBA, 1976 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS IN THE FACULTY OF GRADUATE STUDIES (Department of A d u l t E d u c a t i o n ) We a c c e p t t h i s t h e s i s as c o n f o r m i n g to the r e q u i r e d s t a n d a r d THE UNIVERSITY OF BRITISH COLUMBIA A p r i l , 1980 (g) M a r g e r y G. E. F o r g a y , 1980 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of Brit ish Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the Head of my Department or by his representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of The University of Brit ish Columbia 2 0 7 5 W e s b r o o k P l a c e V a n c o u v e r , C a n a d a V 6 T 1W5 ABSTRACT Although mandatory c o n t i n u i n g education i s an important i s s u e f o r h e a l t h p r o f e s s i o n a l s , l i t t l e r e s e a r c h has been conducted concerning a t t i t u d e s toward i t . In p a r t i c u l a r , there are few I n v e s t i g a t i o n s concerning a t t i t u d e toward mandatory c o n t i n u i n g education and p o s s i b l e s o c i a l or demographic antecedents. T h i s study r e p o r t s the r e s u l t s of a survey of Canadian d e n t a l h y g l e n i s t s designed to determine the extent to which a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n Is u n i - or m u l t i d i m e n s i o n a l . A second purpose was to examine demo- graphic c o r r e l a t e s of a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n . A L l k e r t - t y p e s c a l e was devised to measure a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n . I t was found that the a t t i t u d e i s m u l t i d i m e n s i o n a l , the f i r s t three under- l y i n g f a c t o r s being, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Currentness. Together these three f a c t o r s account f o r 52 per cent of the v a r i a n c e i n a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n . i i Demographic v a r i a b l e s and one p s y c h o l o g i c a l dimension, Conservatism, were examined to determine t h e i r I n f l u e n c e on a t t i t u d e toward mandatory c o n t i n u i n g education and on P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Current- ness. Some s t a t i s t i c a l l y s i g n i f i c a n t r e l a t i o n s h i p s were found. O v e r a l l a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n was c o r r e l a t e d p o s i t i v e l y with the f o l l o w i n g v a r i a b l e s : m i l e s from the nearest d e n t a l hygiene s c h o o l ; CDHA membership; the number of p r o f e s s i o n a l meetings attended i n the past twelve months; o f f i c e s h e l d i n p r o f e s s i o n a l a s s o c i a t i o n s ; per cent of employed years worked f u l l time; the number of c o n t i n u i n g e d u c a t i o n programs attended i n the past twelve months; and l i v i n g where c o n t i n u i n g e d u c a t i o n Is mandatory f o r d e n t i s t s and h y g i e n i s t s . P r o f e s s i o n a l Enhancement scores c o r r e l a t e d p o s i t i v e l y w i t h the same v a r i a b l e s and "attendance a t a d i s c u s s i o n of the Issues concerning mandatory c o n t i n u i n g e d u c a t i o n " . P r o f e s s i o n a l Enhancement scores were n e g a t i v e l y c o r r e l a t e d w i t h the s i z e of the community l i v e d i n . V o l u n t a r i n e s s c o r r e l a t e d n e g a t i v e l y w i t h a l l of the v a r i a b l e s showing p o s i t i v e c o r r e l a t i o n s f o r o v e r a l l f a v o r a b l e - ness toward mandatory c o n t i n u i n g e d u c a t i o n . i i i Program Currentness was p o s i t i v e l y c o r r e l a t e d w i t h years s i n c e g r a d u a t i o n , number of year s spent l n f u l l time t e a c h i n g , number of c h i l d r e n , age, and l o c u s of program of g r a d u a t i o n , and n e g a t i v e l y w i t h CDHA membership and l i v i n g where c o n t i n u i n g e d u c a t i o n Is mandatory f o r d e n t i s t s . Although s t a t i s t i c a l l y s i g n i f i c a n t , these c o r r e l a t i o n s were g e n e r a l l y low. A stepwise m u l t i p l e r e g r e s s i o n showed that few v a r i a b l e s account f o r more than one per cent of the v a r i a n c e i n o v e r a l l a t t i t u d e , P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , or Program Currentness s c o r e s . I t was concluded that a t t i t u d e s of Canadian d e n t a l h y g i e n i s t s toward mandatory c o n t i n u i n g e d u c a t i o n are m u l t i d i m e n s i o n a l and that no independent v a r i a b l e examined was an i n f l u e n t i a l determinant of e i t h e r o v e r a l l a t t i t u d e or i t s three p r i n c i p a l u n d e r l y i n g dimensions. A t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n was not p r e d i c t e d by v a r i a b l e s one would expect to u n d e r l y such a t t i t u d e s . A l t e r n a t i v e l y the i s s u e of mandatory c o n t i n u i n g e d u c a t i o n i s so new that the e f f e c t s of these v a r i a b l e s have not y e t manifested themselves. i v T a b l e o f C o n t e n t s Acknowledgements ..1 A b s t r a c t l i L i s t o f t a b l e s v L i s t o f f i g u r e s v i i i C h apter 1. INTRODUCTION 1 O b j e c t i v e s o f the study . 3 Hypotheses to be examined . .4 2. REVIEW OF THE LITERATURE 7 C o n t i n u i n g e d u c a t i o n f o r h e a l t h p r o f e s s i o n a l s 7 The i s s u e o f mandatory c o n t i n u i n g e d u c a t i o n 9 A t t i t u d e s 12 A c q u i s i t i o n and s t r u c t u r e o f a t t i t u d e s 12 A t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n 17 3 . INSTRUMENT DEVELOPMENT AND METHOD, 18 O p e r a t i o n a l i z i n g the dependent v a r i a b l e 18 O p e r a t i o n a l i z i n g the independent v a r i a b l e s . . . . 1 9 Independent v a r i a b l e s l i s t e d by h y p o t h e s i s . ....20 A d d i t i o n a l demographic v a r i a b l e s - examined . 2 3 Method .... 24 v •• 4». RESULTS 25 C h a r a c t e r i s t i c s of r e s p o n d e n t s 25 D e r i v i n g the MCE S c o r e 27 F a c t o r s t r u c t u r e of t h e MCE S c a l e 28 T e s t i n g the h y p o t h e s e s 33 R e g r e s s i o n a n a l y s i s 53 5. CONCLUSIONS 62 D i s c u s s i o n 66 F u t u r e r e s e a r c h p o s s i b i l i t i e s 70 R e f e r e n c e s 72 Append i c e s 78 vi L i s t o f T a b l e s T a b l e 1 . Item-whole c o r r e l a t i o n s and O r t h o g o n a l l y R o t a t e d F a c t o r L o a d i n g s f o r the MCE S c a l e 29 T a b l e 2 . H i g h L o a d i n g Items by F a c t o r Upon Which They Load 30 T a b l e 3. R e l a t i o n s h i p Between MCE S c o r e , P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program C u r r e n t n e s s and "Remoteness" V a r i a b l e s 3^ T a b l e 4. R e l a t i o n s h i p Between MCE S c o r e , P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program C u r r e n t n e s s and E d u c a t i o n a l Achievement „. ............ .37 T a b l e 5 . R e l a t i o n s h i p Between MCE S c o r e , P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program C u r r e n t n e s s and Involvement w i t h P r o f e s s i o n a l A s s o c i a t i o n s 38 T a b l e 6. R e l a t i o n s h i p Between MCE S c o r e , P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program C u r r e n t n e s s and C a r e e r P a r t i c i p a t i o n 4 l v i i Table 7. R e l a t i o n s h i p Between MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program Currentness and P a r t i c i p a t i o n i n C o n t i n u i n g E d u c a t i o n , « . 4 3 Table 8. R e l a t i o n s h i p Between MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program Currentness and Understanding of and Involvement w i t h Mandatory Co n t i n u i n g E d u c a t i o n . . . . . . 4 5 Table 9 . R e l a t i o n s h i p Between MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program Currentness and Conservatism Score. 49 Table 1 0 . R e l a t i o n s h i p Between MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program Currentness and A d d i t i o n a l Demographic V a r i a b l e s . . . . 51 Table 11 . Summary of Reg r e s s i o n E q u a t i o n : E f f e c t s o f Independent V a r i a b l e s on MCE Score ..... . . . 5 3 Table 1 2 . Summary of Re g r e s s i o n E q u a t i o n : E f f e c t s o f Independent V a r i a b l e s on P r o f e s s i o n a l Enhancement.... 55 v i i i T a b l e 13. Summary o f R e g r e s s i o n E q u a t i o n : E f f e c t s o f Independent V a r i a b l e s on V o l u n t a r i n e s s .57 T a b l e 14. Summary o f R e g r e s s i o n E q u a t i o n : E f f e c t s o f Independent V a r i a b l e s on Program C u r r e n t n e s s , „ 59 i x L i s t o f F i g u r e s F i g u r e 1: Frequency D i s t r i b u t i o n of MCE Scores ..27 ACKNOWLEDGEMENTS I wish to thank the members of my t h e s i s committee f o r t h e i r a s s i s t a n c e . Dr. Roger Bo s h i e r gave me c o n t i n u - ous encouragement, and h i s energy and i n s i g h t f u l n e s s helped s u s t a i n my i n t e r e s t . Dr. Gary D i c k i n s o n ' s response to appeals f o r a s s i s t a n c e was always prompt, s u c c i n c t , and h e l p f u l . Dr. Farouk Chebib was of great help i n s e l e c t i n g and i n t e r p r e t i n g the s t a t i s t i c a l a n a l y s es employed. I am e s p e c i a l l y g r a t e f u l to the h y g i e n i s t s who p a r t i c i - pated i n t h i s survey, and to the Canadian Dental H y g i e n i s t s ' A s s o c i a t i o n f o r p r o v i d i n g the l i s t s of h y g i e n i s t s r e g i s t e r e d to p r a c t i s e i n Canada. My c h i l d r e n , A l i s o n , David and Donald gave me t o l e r a n c e , understanding and encouragement during my endeavors. My husband, Ray, pro v i d e d me not only w i t h love and support but w i t h a model of perseverance and w i l l to triumph over d i f f i - c u l t i e s . He has been h e l p f u l , generous, and i n s i s t e d that I continue when other pressures would have made i t e a s i e r to d i s c o n t i n u e . xi 1. Chapter 1 In r e l a t i o n to the h e a l t h p r o f e s s i o n s , c o n t i n u i n g e d u c a t i o n i s d e s c r i b e d as that o c c u r r i n g a f t e r b a s i c prepar- a t i o n f o r p r a c t i c e i s completed, and which has a b e a r i n g on the d e l i v e r y of s e r v i c e s to the p u b l i c . The e d u c a t i o n may be f o r c r e d i t or n o n - c r e d i t , formal or i n f o r m a l , planned or i n c i d e n t a l , s e l f - or other - d i r e c t e d ( S t u a r t , 1975). The p r a c t i c e of many h e a l t h p r o f e s s i o n a l s i s l i m i t e d to those who are r e g i s t e r e d , c e r t i f i e d , or l i c e n s e d by governments or t h e i r agents. A v o i d i n g obsolescence i s regarded as a prime r e s p o n s i b i l i t y o f the h e a l t h p r o f e s s i o n a l ; c o n t i n u i n g e d u c a t i o n i s e s s e n t i a l to a v o i d obsolescence. Presumably a l l members of h e a l t h p r o f e s s i o n s need c o n t i n u i n g e d u c a t i o n . In r e c e n t years there has been an I n c r e a s i n g t r e n d f o r members of h e a l t h p r o f e s s i o n s to provide proof of p a r t i c i p a t i o n i n a s p e c i f i e d amount and type of c o n t i n u i n g e d u c a t i o n to ma i n t a i n c r e d e n t i a l s necessary f o r p r a c t i c e . The i s s u e of mandatory c o n t i n u i n g e d u c a t i o n i s t h e r e f o r e one of c o n s i d e r a b l e c u r r e n t i n t e r e s t and the s u b j e c t of j o u r n a l a r t i c l e s , surveys, e d i t o r i a l s , conferences, and l e g i s l a t i o n . 2. A wide range of a t t i t u d e s concerning mandatory con- t i n u i n g e d u c a t i o n r a n g i n g from s t r o n g o p p o s i t i o n , ambivalence, to s t r o n g a p p r o v a l appeals to e x i s t . There a r e , however, few r e s e a r c h s t u d i e s d e a l i n g d i r e c t l y w i t h a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n . In p a r t i c u l a r , there are no r e p o r t s i n the l i t e r a t u r e on p o s s i b l e demographic or other antecedents of a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n , or whe.ther that a t t i t u d e c o n t a i n s more than one dimension. Mandatory c o n t i n u i n g e d u c a t i o n e n t a i l s committments of l a r g e sums of money, e d u c a t i o n a l r e s o u r c e s , i n c r e a s e d a d m i n i s t r a t i o n and r e c o r d keeping, d i f f i c u l t d e c i s i o n s concerning who w i l l p r e s c r i b e the amount and type of edu c a t i o n r e q u i r e d , d i f f i c u l t i e s f o r many i n d i v i d u a l s i n conforming to requirements, and a b a s i c change i n the phil o s o p h y of the v o l u n t a r y nature o f c o n t i n u i n g e d u c a t i o n f o r h e a l t h p r o f e s s i o n a l s . In view of these s i g n i f i c a n t i m p l i c a t i o n s , i t i s s u r p r i s i n g that r e s e a r c h concerning the determinants of a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n has not been undertaken. I f such determinants can be a s c e r t a i n e d , understanding o f t h i s c o n t r o v e r s i a l , sometimes emotional i s s u e w i l l be enhanced. O b j e c t i v e s of the Study T h i s study was designed to i n v e s t i g a t e the f o l l o w i n g u e s t i o n s : 1. Is a t t i t u d e toward.mandatory c o n t i n u i n g e d u c a t i o n i n a group of Canadian d e n t a l h y g i e n i s t s u n i d i m e n s i o n a l or m u l t i d i m e n s i o n a l ? Does i t r e f l e c t a s i n g l e g e n e r a l p r e d i s p o s i t i o n , or are there s e v e r a l u n d e r l y i n g f a c t o r s ? 2. To what extent i s a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n I n f l u e n c e d by demo- gr a p h i c and other f a c t o r s , such as: remote- ness from d e n t a l hygiene e d u c a t i o n c e n t r e s ; years s i n c e g r a d u a t i o n ; program of gr a d u a t i o n ; i n c r e a s e d e d u c a t i o n a l achievement; involvement i n p r o f e s s i o n a l d e n t a l hygiene o r g a n i s a t i o n s ; c a r e e r p a r t i c i p a t i o n ; p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n ; involvement with mandatory c o n t i n u i n g e d u c a t i o n ; age; m a r i t a l s t a t u s ; sex; s i z e of community of r e s i d e n c e ; number of c h i l d r e n ; and g e n e r a l conservatism? 4 . Hypotheses to be Examined Because of the l a c k of r e p o r t e d r e s e a r c h concerning a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n , t h i s r e s e a r c h was l a r g e l y i n d u c t i v e . A panel of twenty h y g i e n i s t s was asked to a s s i s t by d e s c r i b i n g f a c t o r s that they f e l t had i n f l u e n c e d t h e i r own a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n . S e v e r a l a d d i t i o n a l f a c t o r s were chosen on an a p r i o r i b a s i s , i n c l u d i n g demographic v a r i a b l e s and one p e r s o n a l i t y c h a r a c t e r i s t i c : conservatism. Conservatism was chosen because i t was thought l i k e l y to be a p e r s o n a l i t y c h a r a c t e r i s t i c of i n f l u e n c e i n a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n , since i t has been l i n k e d with conformity, I n t o l e r a n c e of ambiguity and a u t h o r i t a r i a n i s m (Hicks, 1974) . A l s o , a r e l a t i v e l y simple s c a l e to measure conservatism i s a v a i l a b l e (Wilson, 1973) . Most of the v a r i a b l e s suggested by the panel or s e l e c t e d by the i n v e s t i g a t o r were used to formulate the f o l l o w i n g seven hypotheses. 5. Hypothesis One Dental h y g i e n i s t s "remote" ( i n terms of l i v i n g f a r t h e r from d e n t a l hygiene and d e n t a l schools and having graduated long ago) w i l l be l e s s f a v o r a b l y disposed toward mandatory c o n t i n u i n g e d u c a t i o n than h y g i e n i s t s who l i v e c l o s e to d e n t a l hygiene and d e n t a l schools and have graduated r e c e n t l y . Hypothesis Two Dental h y g i e n i s t s w i t h "high" l e v e l s of e d u c a t i o n a l achievement w i l l be more f a v o r a b l y disposed toward mandatory c o n t i n u i n g e d u c a t i o n than those w i t h "low" l e v e l s o f e d u c a t i o n a l achievement. Hypothesis Three Dental h y g i e n i s t s a c t i v e l y i n v o l v e d w i t h p r o f e s s i o n a l o r g a n i s a t i o n s w i l l be more f a v o r a b l y disposed to mandatory c o n t i n u i n g e d u c a t i o n than h y g i e n i s t s l e s s a c t i v e l y i n v o l v e d . Hypothesis Four Dental h y g i e n i s t s who have p a r t i c i p a t e d more a c t i v e l y i n a c a r e e r i n d e n t a l hygiene w i l l be more f a v o r a b l y d i s - posed to mandatory c o n t i n u i n g e d u c a t i o n than h y g i e n i s t s w i t h l e s s p a r t i c i p a t i o n i n a dental hygiene c a r e e r . Hypothesis Five Dental hygienists with higher levels of p a r t i c i p a t i o n i n continuing education w i l l have a more favorable attitude toward mandatory continuing education than hygienists with lower continuing education p a r t i c i p a t i o n l e v e l s . Hypothesis Six Dental hygienists who have considered the issues surrounding mandatory continuing education and have had experience with i t w i l l be more favorably disposed toward mandatory continuing education than hygienists who have not considered the issues or had experience with i t . Hypothesis Seven Conservative dental hygienists w i l l be more l i k e l y to favor mandatory continuing education than " l i b e r a l " hygienists. 7. Chapter 2 Review of the L i t e r a t u r e Continuing Education f o r H e a l t h P r o f e s s i o n a l s Although c o n t i n u i n g e d u c a t i o n i s widely accepted as d e s i r a b l e , the premise t h a t i t i s an e f f e c t i v e mechanism to ensure competence i s not f u l l y supported by r e s e a r c h . Houle (1976) r e p o r t e d a l i n k between c o n t i n u i n g e d u c a t i o n and competence but e a r l i e r s t u d i e s (eg. Lewis, 1970, S h a e f f e r et a l , 1970) f a i l e d to e s t a b l i s h any r e l a t i o n s h i p . P a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n courses v a r i e s widely w i t h i n any h e a l t h p r o f e s s i o n . A study of nurses i n the U n i t e d S t a t e s by Kubat (1975) r e v e a l e d that most had not attended any c o n t i n u i n g e d u c a t i o n a c t i v i t i e s . In a review of the l i t e r a t u r e on c o n t i n u i n g e d u c a t i o n i n d e n t i s t r y , Nakamoto and Verner (1972) found t h a t i n the United S t a t e s only f i f t e e n to 25 per cent of d e n t i s t s r e g u l a r l y a t t e n d c o n t i n u i n g e d u c a t i o n courses. E a r l i e s t r e p o r t s of c o n t i n u i n g e d u c a t i o n courses s p e c i f i c a l l y designed f o r d e n t a l h y g i e n i s t s appear i n the l i t e r a t u r e i n the e a r l y 194o's (ADHA 194l). K l i n e (1975) s t u d i e d p a r t i c i p a t i o n p a t t e r n s i n c o n t i n u i n g e d u c a t i o n of d e n t a l h y g i e n i s t s i n B r i t i s h Columbia. She found t h a t 8 . 6 8 . 7 per cent of hygienists had attended continuing education courses over a three year period, March 1 9 7 1 to March 1 9 7 4 . She also found p a r t i c i p a t i o n to be unrelated to age, marital status, number of children, year of graduation, l e v e l of education attained, or employment status. Graduates of dental hygiene programs i n the United States participated more i n continuing education programs than Canadian graduates (p < .02). The socio-economic variables examined had l i t t l e influence on p a r t i c i p a t i o n patterns of B r i t i s h Columbia dental hygienists. In a survey of 2020 Michigan dental hygienists, Malvltz and Judge ( 1 9 7 6 ) found that 21 per cent had never participated i n a continuing education a c t i v i t y , and an additional thirteen per cent had not done so in more than three years. P a r t i c i p a t i o n rates were higher for hygienists who belonged to the Michigan Dental Hygienists 1 Association, worked f u l l time, and had education beyond the diploma l e v e l . The fact n o f r a l l health professionals participate i n continuing education i s one of the chief reasons given i n support of mandatory continuing education. It i s argued that i f education i s necessary to ensure competence, i t i s e s s e n t i a l that a l l professionals p a r t i c i p a t e . 9. The Issue of Mandatory Continuing E d u c a t i o n Neylan (197^), i n a l i t e r a t u r e review on m a i n t a i n i n g the competence of h e a l t h p r o f e s s i o n a l s , summarized the arguments f o r and a g a i n s t mandatory c o n t i n u i n g e d u c a t i o n . Arguments i n f a v o r i n c l u d e : 1. P u b l i c funding o f h e a l t h s e r v i c e s r e q u i r e s q u a l i t y c o n t r o l over these s e r v i c e s . 2. P a r t i c i p a t i o n r a t e s i n v o l u n t a r y c o n t i n u i n g e d u c a t i o n are low, 3. Mandatory c o n t i n u i n g e d u c a t i o n w i l l improve the p u b l i c image of the p r o f e s s i o n s . 4. I f c o n t i n u i n g e d u c a t i o n i s mandatory, i t w i l l help secure p u b l i c funds f o r c o n t i n u i n g e d u c a t i o n ( s i m i l a r to undergraduate and graduate e d u c a t i o n f u n d i n g ) . 5. Mandatory c o n t i n u i n g e d u c a t i o n w i l l f a c i l i t a t e s e l f - r e g u l a t i o n w i t h i n the p r o f e s s i o n s . 6. P a r t i c i p a t i o n i n p r o f e s s i o n a l a s s o c i a t i o n s w i l l i n c r e a s e i f c o n t i n u i n g e d u c a t i o n i s mandatory. 10. Arguments against mandatory continuing education include: 1. P o l i c i n g requirements w i l l be cos t l y . 2. There i s no evidence that mandatory continuing education has a positive impact on care. 3. Access to current information for health pro- fessionals i s greatly improved. 4 . Adults cannot be coerced Into learning. 5. Coercion may induce a r e b e l l i o u s attitude m i t i - gating against learning. 6. Compulsion does not generate s e l f - d i r e c t i o n , motivation to learn, or a sense of accountability. 7. Coercion i s an Infringement of c i v i l r i g h t s . 8. It i s d i f f i c u l t to "prescribe" education for health professionals because of differences i n rol e s , settings, and c l i e n t e l e . 9. Accreditation mechanisms for continuing education are underdeveloped. 10. Mandatory continuing education w i l l generate dependency on i n s t i t u t i o n s rather than a desired emphasis on s e l f - d i r e c t e d learning. 1 1 . I n s p i t e of the c o n t r o v e r s y , mandatory c o n t i n u i n g e d u c a t i o n has been i n c r e a s i n g i n the 1970S; i t i s a n t i c i p a t e d that the t r e n d w i l l continue (Pearlman 1 9 7 4 , Derbyshire 1 9 7 6 ) . H e a l t h personnel are more l i k e l y than those i n other types of o c c u p a t i o n s to r e q u i r e c o n t i n u i n g e d u c a t i o n and, w i t h i n the h e a l t h occupations, longer e s t a b l i s h e d p r o f e s s i o n s are more l i k e l y to espouse mandatory c o n t i n u i n g e d u c a t i o n . Many emerging groups of h e a l t h workers, however, a l s o seek mandatory c o n t i n u i n g e d u c a t i o n (Derbyshire 1 9 7 6 ) . D e n t i s t r y has tended to l e a d the t r e n d toward man- datory c o n t i n u i n g e d u c a t i o n ( S t r o t h e r and Swinford 1 9 7 5 ) . At present, three p r o v i n c e s and seven s t a t e s i n the U n i t e d S t a t e s r e q u i r e c o n t i n u i n g education f o r d e n t i s t s . Twenty-eight a d d i t i o n a l s t a t e s have the matter under c o n s i d e r a t i o n . Of these, f i v e p l a n to i n s t i t u t e mandatory c o n t i n u i n g e d u c a t i o n w i t h i n three years (ADA 1 9 7 8 ) . Ten s t a t e s have c o n t i n u i n g e d u c a t i o n requirements f o r r e l i c e n s u r e of d e n t a l h y g i e n i s t s (ADA 1 9 7 9 ) . In Canada, B r i t i s h Columbia i n s t i t u t e d mandatory c o n t i n u i n g e d u c a t i o n f o r d e n t a l h y g i e n i s t s i n January 1 9 7 9 (BCDHA, 1 9 7 9 ) . In Saskatchewan, Nova S c o t i a , and Manitoba, the q u e s t i o n i s under review. In l i g h t of the i n c r e a s i n g trend toward mandatory c o n t i n u i n g e d u c a t i o n which must r e f l e c t a f a v o r a b l e a t t i t u d e toward i t , an understanding of the a c q u i s i t i o n . a n d s t r u c t u r e of a t t i t u d e s i s p e r t i n e n t . Acquisition and Structure of Attitudes In 1935, A l l p o r t defined an attitude as "...a mental and neural state of readiness, organised through experience, exerting a dir e c t i v e or dynamic influence upon the indiv i d u a l ' s responses to a l l objects and situations with which i t i s related." Katz (I960) defined attitude as "...the predisposition of an ind i v i d u a l to evaluate some symbol or object or aspect of his world i n a favorable or unfavorable manner." Trlandis (1971) proposed the following d e f i n i t i o n ; "An attitude i s an idea charged with emotion which predisposes a class of actions to a p a r t i c u l a r class of s o c i a l s i t u a t i o n s . " A l l p o r t stresses the eff e c t of experience i n developing a t t i t u d e s . Katz Introduces the concept of attitude being evaluative i n nature. The Trlandis d e f i n i t i o n l i n k s attitude with the feelings of the i n d i v i d u a l in saying that emotion i s an i n t e g r a l part of attitu d e . Although there i s some difference i n the d e f i n i t i o n s , there i s agreement that attitudes predispose individuals to act toward objects or si t u a t i o n s . 1 3 . A c q u i s i t i o n of A t t i t u d e s A t t i t u d e s appear to be l e a r n e d . H a l l o r a n (1970) r e p o r t e d t h a t a t t i t u d e s are developed, organised, and changed through the e x p e r i e n c e s : of ..the i n d i v i d u a l , and that these processes f o l l o w standard p r i n c i p l e s of l e a r n i n g . He c i t e s three main sources o f a t t i t u d e f o r m a t i o n : d i r e c t experiences w i t h o b j e c t s and s i t u a t i o n s ; p e r s o n a l i t y development; and e x p l i c i t and i m p l i c i t l e a r n i n g from o t h e r s . Included i n the l a t t e r i s the i n f l u e n c e o f group a f f i l i a t i o n , there being a tendency f o r the i n d i v i d u a l to r e f l e c t the a t t i t u d e s and norms of the group w i t h whom he i d e n t i f i e s . Reagan and F a z i o (1977) suggest that d i r e c t b e h a v i o r a l experiences produce a t t i t u d e s which are more c l e a r l y and s t a b l y maintained than those formed through more i n d i r e c t means. T r l a n d i s (1971) s t a t e s that a t t i t u d e s can be l e a r n e d by both c l a s s i c a l and operant c o n d i t i o n i n g . The former occurs when some r e i n f o r c i n g event i s a s s o c i a t e d w i t h a n o n - r e i n f o r c i n g event, and the l a t t e r when a response of the i n d i v i d u a l i s f o l l o w e d by a r e i n f o r c i n g event. In oth e r words, an a t t i t u d e o b j e c t may be l i n k e d w i t h a rewarding s i t u a t i o n ( c l a s s i c a l c o n d i t i o n i n g ) , or a s p e c i f i c type of behavior may be f o l l o w e d by re i n f o r c e m e n t , producing a t t i t u d e s which j u s t i f y the beh a v i o r (operant c o n d i t i o n i n g ) . 14. S t a a t s (1967) showed that a t t i t u d i n a l s t i m u l i are c o n d i t i o n e d s t i m u l i t h a t through c l a s s i c a l c o n d i t i o n i n g come to e l i c i t emotional responses. Higher order c o n d i t i o n i n g i s the b a s i s f o r g e n e r a l i z e d a t t i t u d i n a l responses. S i m i l a r l y , operant c o n d i t i o n i n g of a t t i t u d e s r e s u l t s from r e i n f o r c e r s such as r e s p e c t , a c c l a i m , s o c i a l and p e r s o n a l a t t e n t i o n , contingent upon some behaviours but not o t h e r s . A p p l i c a t i o n o f hi g h e r order c o n d i t i o n i n g to a t t i t u d e f o r m a t i o n was a l s o observed by Kanekar (1976), who found t h a t i f a model e x h i b i t e d p o s i t i v e or negative emotional behavior i n the context of a p a r t i c u l a r s i t u a t i o n , the r e l e v a n t emotion was a l s o produced i n the obs e r v e r . Rhine (1967) l i n k e d the a c q u i s i t i o n o f a t t i t u d e w i t h concept f o r m a t i o n . He d e s c r i b e s a concept as a p s y c h o l - o g i c a l mechanism r e p r e s e n t i n g a set of stimulus p a t t e r n s , and an a t t i t u d e as be i n g a concept w i t h an e v a l u a t i v e dimension. The e s s e n t i a l c o n d i t i o n f o r . comcept f o r m a t i o n i s the a s s o c i a t i o n between a common response and a v a r i e t y of s t i m u l i . T h i s common response r e p r e s e n t s a common mediating p r o c e s s . M e d i a t i n g processes are more d i s - c r i m i n a t i n g and l e s s o v e r t the more mature and i n t e l l i g e n t the organism or i n d i v i d u a l i s . V e r b a l mediators are the most s i g n i f i c a n t and these i n t u r n become s t i m u l i f o r second order concepts. An a t t i t u d e r e s u l t s when at l e a s t one o f the f i r s t order concepts i s an e v a l u a t i v e r e a c t i o n . 1 5 . S t r u c t u r e o f A t t i t u d e s T r l a n d i s (1971) d e s c r i b e s a t t i t u d e s as having three b a s i c components: c o g n i t i v e or b e l i e f elements which d e s c r i b e and p e r c e i v e the o b j e c t ; an a f f e c t i v e component, or core f e e l i n g o f l i k i n g or d i s l i k i n g ; and a b e h a v i o r a l component, a tendency to act or behave i n a p a r t i c u l a r way. There i s evidence (Rosenberg 1 9 5 6 , Woodmansee and Cook 1967) that the c o g n i t i v e , a f f e c t i v e , and b e h a v i o r a l components are h i g h l y I n t e g r a t e d . T r l a n d i s (1971) proposes t h a t the three components are d i s t i n c t , and should be measured s e p a r a t e l y . I f , however, the a t t i t u d e s under I n v e s t i g a t i o n are very s p e c i f i c , f a c t o r a n a l y s i s w i l l r e v e a l dimensions t h a t r e p r e s e n t mixtures of the three components. Eysenck ( i 9 6 0 ) argued that there are two dimensions to p o l i t i c a l a t t i t u d e : r a d i c a l i s m - c o n s e r v a t i s m , and toughminded- ness-tendermindedness. In a study of Canadian p o l i t i c a l a t t i t u d e s , Singh ( 1 9 7 7 ) found two f a c t o r s corresponding c l o s e l y to these dimensions. In a s i m i l a r v e i n , T r l a n d i s ( 1 9 7 1 ) r e l a t e d p o l i t i c a l a t t i t u d e s to two o r t h o g o n a l l y r e l a t e d dimensions: concern f o r c o l l e c t i v i t y / c o n c e r n f o r the i n d i v i d u a l , and b e l i e f i n s c i e n t i f i c b a s i s f o r change/ b e l i e f i n change from c h a r i s m a t i c l e a d e r s h i p . Comrey and Newmeyer (1965) i n a study of the a t t i t u d i n a l dimension of r a d i c a l i s m / c o n s e r v a t i s m found f i v e separate f a c t o r s : r e l i g i o u s a t t i t u d e ; p u n i t i v e a t t i t u d e ; n a t i o n a l i s m ; w e l f a r e s t a t e a t t i t u d e ; and r a c i a l t o l e r a n c e . R e l a t i v e l y independent a t t i t u d e dimensions were a l s o found i n a study of a t t i t u d e s toward human f e r t i l i t y (Gaughran et a l 1 9 7 6 ) . A t t i t u d e s do not e x i s t as separate i s o l a t e d e n t i t i e s but are seen to o v e r l a p , I n t e g r a t e , and g e n e r a l l y e x i s t i n a s t a t e of homeostasis i n an i n d i v i d u a l ( H a l l o r a n 1 9 7 0 ) . Rokeach ( i 9 6 0 , 1968) s t a t e d that a t t i t u d e s are best under- stood as r e l a t i n g to broad b e l i e f systems, such as open mindedness - c l o s e mindedness. S i m i l a r l y , Wilson (1973) and h i s c o l l e a g u e s argued that most, I f not a l l s o c i a l a t t i t u d e s are u n d e r l a i n by a ge n e r a l conservatism f a c t o r . T h e i r work r e s u l t e d i n a simple s c a l e measuring the c o n s e r v a t i s m / l i b e r a l i s m . T h i s g e n e r a l f a c t o r i s ma n i f e s t e d i n c o r r e l a t i o n s amongst d i f f e r e n t a t t i t u d e areas and concerns a r e s i s t a n c e t o change, and a tendency to p r e f e r s a f e , t r a d i t i o n a l , and c o n v e n t i o n a l forms of i n s t i t u t i o n s and be h a v i o r . Hicks (197*0 found conservatism to c o r r e l a t e w i t h a tendency to conform, i n t o l e r a n c e of ambiguity, and a u t h o r i t a r i a n i s m . 17. A t t i t u d e s Toward Mandatory C o n t i n u i n g E d u c a t i o n R e s e a r c h c o n c e r n i n g a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n appears t o be l i m i t e d to su r v e y s on the q u e s t i o n o f b e i n g " f o r o r a g a i n s t " and to q u e s t i o n s c o n c e r n i n g format and t o p i c s (Bauer and Bush 1978, C a f f e r a t a e t a l 1975, K e e v i l and C a r t w r i g h t 1976, 1978) . Snyder and S c h a l g e m e i r (1973) r e l a t e d background c h a r a c t e r i s t i c s o f M i c h i g a n d e n t i s t s w i t h p a r t i c i p a t i o n r a t e s i n c o n t i n u i n g e d u c a t i o n a c t i v i t i e s i n a J u r i s d i c t i o n where c o n t i n u i n g e d u c a t i o n was v o l u n t a r y . K l i n e (1975) d i d the same f o r d e n t a l h y g i e n i s t s i n B r i t i s h C olumbia. No r e p o r t s c o u l d be found which r e l a t e background c h a r a c t e r i s t i c s o f i n d i v i d u a l s to t h e i r a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n . Chapter 3 Instrument Development and Method O p e r a t l o n a l l z a t l o n of the Dependent V a r i a b l e In order to measure the dependent v a r i a b l e , a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n , a Mandatory C o n t i n u i n g E d u c a t i o n S c a l e , a L i k e r t type s c a l e con- s i s t i n g of t h i r t e e n items, was c o n s t r u c t e d . For each item a seven-point s c a l e : s t r o n g l y d i s a g r e e , moderately d i s a g r e e , m i l d l y d i s a g r e e , n e u t r a l , m i l d l y agree, moder- a t e l y agree, and s t r o n g l y agree, was used. T h i r t e e n items were c o n s t r u c t e d to measure d i f f e r e n c e s l n a t t i t u d e toward and a n t i c i p a t e d r e s u l t s of mandatory c o n t i n u i n g e d u c a t i o n ( i n d i f f e r e n t c i r c u m s t a n c e s ) . The t h i r t e e n item s c a l e i s shown i n P a r t One, Appendix A. Values of one to seven were assig n e d to responses to each o f the t h i r t e e n items of the MCE S c a l e . These v a l u e s correspond to the responses s t r o n g l y d i s a g r e e , moder- a t e l y d i s a g r e e , m i l d l y d i s a g r e e , n e u t r a l , m i l d l y agree, moderately agree, and s t r o n g l y agree. The values of seven to one were assig n e d to the responses of the s i x items (numbers 2 , 4 , 5 , 7 , 1 0 , and 1 1 ) where r e v e r s e scoring was used. The MCE Score for each respondent was derived by summing over scores for responses to each of the thirteen items. The items of the scale include such statements as: 1. Continuing education should be mandatory for a l l hygienists. 2. Dental hygienists who teach i n dental a u x i l i a r y programs should be exempt from mandatory continuing educ- ation requirements. In order to reveal the p r i n c i p a l dimensions underlying attitude toward mandatory continuing education a factor analysis of scores for the thirteen items of the scale was performed. The f i r s t three r e s u l t i n g factor scores were subsequently treated as dependent variables. Operatlonalization of the Independent Variables Because of the lack of previous research into deter- minants of attitudes toward mandatory continuing education, t h i s research was e s s e n t i a l l y inductive i n nature. It was surmised that the attitude toward mandatory continuing education would be influenced by several types of variables, such as l e v e l of education, distance from dental hygiene education centres, years since graduation, and involvement with professional dental hygiene organisations. 2 0 . Because these assumptions were l a r g e l y i n t u i t i v e l y d e r i v e d by the i n v e s t i g a t o r , i t was decided to e n l i s t the a s s i s t a n c e o f twenty d e n t a l h y g i e n i s t s from a c r o s s Canada.. Twelve were employed i n c l i n i c a l p r a c t i c e , three i n a u x i l i a r y e d u c a t i o n , and three i n p u b l i c h e a l t h , while two were not c u r r e n t l y a c t i v e i n t h e i r p r o f e s s i o n . A p r e l i m i n a r y request e x p l a i n e d the nature of the r e s e a r c h and asked panel members to l i s t a l l f a c t o r s they thought had been i n f l u e n t i a l i n determining t h e i r a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n . In a d d i t i o n , the panel was asked to rank a s e r i e s o f seven o f f i c e s and p o s i t i o n s l n p r o f e s s i o n a l p r o v i n c i a l and n a t i o n a l a s s o c i a t i o n s i n d i c a t i n g a g r a d u a t i o n from " l e s s involvement" to "more involvement." A i l twenty panel members responded.' These responses, together with some a p r i o r i s e l e c t i o n s of the i n v e s t i g a t o r , were used to s e l e c t and o p e r a t i o n a l i z e the Independent v a r i a b l e s as f o l l o w s : Hypothesis One: Remoteness from d e n t a l hygiene e d u c a t i o n 1. M i l e s d i s t a n t from n e a r e s t d e n t a l hygiene e d u c a t i o n program 2 . M i l e s d i s t a n t from nearest f a c u l t y of d e n t i s t r y 3. Years s i n c e graduation 21. Hypothesis Two: E d u c a t i o n a l achievement 1. A s c a l e was c o n s t r u c t e d i n d i c a t i n g the f o l l o w i n g l e v e l s of e d u c a t i o n a c h i e v e d : diploma i n d e n t a l hygiene; diploma p l u s a d d i t i o n a l c r e d i t courses toward a degree; diploma p l u s b a c h e l o r s degree; diploma p l u s masters degree. Hypothesis Three: Involvement i n p r o f e s s i o n a l a s s o c i a t i o n s 1. Membership i n the Canadian Dental H y g i e n i s t s ' Assoc- i a t i o n , (CDHA). 2. Attendance at a s s o c i a t i o n meetings f o r the past twelve months. 3. Attendance at n a t i o n a l conventions f o r the past f i v e y e a r s . 4. O f f i c e s h e l d i n p r o v i n c i a l and n a t i o n a l a s s o c i a t i o n s . The f o l l o w i n g s c a l e r e s u l t e d from the ra n k i n g of the twenty member panel o f seven o f f i c e s or p o s i t i o n s i n order of i n c r e a s i n g involvement: a. p r o v i n c i a l committee member b. n a t i o n a l committee member c. p r o v i n c i a l committee chairman d. p r o v i n c i a l e x e c utive member e. n a t i o n a l committee chairman f . CDHA Board member g. CDHA e x e c u t i v e member 22. Hypothesis Four: Career p a r t i c i p a t i o n 1. Years worked as a de n t a l h y g i e n i s t 2. Per cent of those years worked f u l l time 3 . Current employment as a d e n t a l h y g i e n i s t 4. Experience t e a c h i n g f u l l or p a r t time i n d e n t a l a u x i l i a r y e d u c a t i o n . Hypothesis F i v e : P a r t i c i p a t i o n l n c o n t i n u i n g e d u c a t i o n 1. Number of c o n t i n u i n g e d u c a t i o n a c t i v i t i e s attended i n the past twelve months 2. P r e s e n t a t i o n of c o n t i n u i n g e d u c a t i o n programs Hypothesis S i x : C o n s i d e r a t i o n of the i s s u e s and experience with mandatory c o n t i n u i n g e d u c a t i o n 1. Attendance at a meeting or d i s c u s s i o n about mandatory c o n t i n u i n g e d u c a t i o n 2. E x i s t e n c e of mandatory c o n t i n u i n g e d u c a t i o n f o r h y g i e n i s t s i n t h a t j u r i s d i c t i o n 3 . E x i s t e n c e of mandatory c o n t i n u i n g e d u c a t i o n f o r d e n t i s t s i n t h a t j u r i s d i c t i o n 2 3 . Hypothesis Seven: Conservatism 1 . Tho Conservatism Scale developed by Wilson e t . a l . (1973) was used to o p e r a t i o n a l i z e conservatism. T h i s s c a l e , u n i d e n t i f i e d so as not to i n f l u e n c e responses, was i n c l u d e d as Part I I I of the q u e s t i o n n a i r e (See Appendix A). A d d i t i o n a l demographic v a r i a b l e s Because of the i n d u c t i v e nature of the r e s e a r c h , some' a d d i t i o n a l demographic v a r i a b l e s were i n c l u d e d i n the q u e s t i o n n a i r e . While i t was f e l t these v a r i a b l e s might have some i n f l u e n c e on a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n , they were not i n c l u d e d f o r hyp o t h e s i s t e s t i n g purposes. These v a r i a b l e s were: 1 . Sex 2 . M a r i t a l S t a t u s 3. Number of C h i l d r e n 4 . S i n g l e parent s t a t u s 5. Age 6. F i e l d of employment 7. Program of gr a d u a t i o n i n d e n t a l hygiene 8. S i z e o f community of r e s i d e n c e V a r i a b l e s were or g a n i s e d i n t o a q u e s t i o n n a i r e which was p r e t e s t e d by the twenty member panel before being f i n a l i s e d . The f i n a l q u e s t i o n n a i r e appears as Appendix A. 2 4 . Method S u b j e c t s and d e s i g n Data f o r the "main" s t u d y were o b t a i n e d from a survey o f d e n t a l h y g i e n i s t s l i c e n s e d t o p r a c t i c e i n Canada. The l i s t o f h y g i e n i s t s from which the sample was drawn was o b t a i n e d from the Canadian D e n t a l H y g i e n i s t s ' A s s o c i a t i o n , and i n c l u d e d a i l h y g i e n i s t s r e g i s t e r e d t o p r a c t i c e i n the ten p r o v i n c e s i o f Canada i n 1978. B o t h members and non-members o f the Canadian D e n t a l H y g i e n i s t s ' A s s o c i a t i o n were i n c l u d e d : 1638 were members o f CDHA and 1498 were non-members, f o r a t o t a l o f 3136. The sample was d e r i v e d by d i v i d i n g the l i s t i n t o members and non-members, and s e l e c t i n g e v e r y s i x t h name on each l i s t , g i v i n g a sample s i z e o f 5 2 2 . Q u e s t i o n n a i r e s were numbered t o a l l o w f o r a f o l l o w - u p o f non-res p o n d e n t s . F i v e hundred and twenty-two q u e s t i o n n a i r e s accompanied by a c o v e r i n g l e t t e r shown i n Appendix B were m a i l e d on January 5 , 1979. Twenty- t h r e e q u e s t i o n n a i r e s were r e t u r n e d by the post o f f i c e as , b e i n g u n d e l l v e r a b l e because o f i n c o r r e c t a d d r e s s e s , l e a v i n g a sample p o p u l a t i o n o f 4 9 9 . By F e b r u a r y 1 5 t h , 1979, 231 r e s p o n s e s had been r e c e i v e d . On t h a t date a f o l l o w - u p p o s t c a r d was sent t o non-respondents as a r e m i n d e r . An a d d i t i o n a l 73 q u e s t i o n n a i r e s were r e c e i v e d a f t e r F e b r u a r y 1 5 t h f o r a t o t a l response o f 304 or 6 0 . 8 per c e n t . Chapter 4 R e s u l t s T h i s study was d e s i g n e d to a s c e r t a i n the e x t e n t to w h i c h c e r t a i n v a r i a b l e s i n f l u e n c e the a t t i t u d e o f a group o f Canadian d e n t a l h y g i e n i s t s toward mandatory c o n t i n u i n g e d u c a t i o n . Another q u e s t i o n concerned the e x t e n t t o w h i c h a t t i t u d e s o f h y g i e n i s t s toward mandatory c o n t i n u i n g edu- c a t i o n are u n i d i m e n s i o n a l o r composed o f s e v e r a l d i s t i n c t u n d e r l y i n g f a c t o r s . The r e s u l t s o f the i n v e s t i g a t i o n are r e p o r t e d as f o l l o w s There i s an i n i t i a l d e s c r i p t i o n o f the c h a r a c t e r i s t i c s o f the r e s p o n d e n t s . T h i s i s f o l l o w e d by the MCE Score and the f a c t o r s t r u c t u r e o f the MCE S c o r e . Next, r e s u l t s p e r t a i n i n g t o the seven hypotheses s t a t e d i n Chapter 1 are p r e s e n t e d . T h i s i s f o l l o w e d by r e g r e s s i o n a n a l y s e s where the MCE Score was the dependent v a r i a b l e . C h a r a c t e r i s t i c s o f the r e s p o n d e n t s Three hundred and f o u r o f the 499 h y g i e n i s t s s u r v e y e d responded, g i v i n g a response r a t e of 6 l per c e n t . As e x p e c t e d , r e s p o n d e n t s were almost a l l female ( 9 6 . 7 per c e n t ) , and young, the average age b e i n g 2 7 . 5 y e a r s (S.D. = 5 . 5 ) . The average respondent had g r a d u a t e d s i x y e a r s ago and worked as a d e n t a l h y g i e n i s t f o r f i v e y e a r s . Twenty-nine per cent g r a d u a t e d from community c o l l e g e based programs, and 71 per cent from u n i v e r s i t y based programs. E i g h t y per cent were employed as h y g i e n i s t s a t the time o f the s u r v e y . Most r e s p o n d e n t s (70 per c e n t ) were members o f CDHA, a l t h o u g h 73 per cent had never h e l d any p r o v i n c i a l o r n a t i o n a l o f f i c e i n d e n t a l hygiene o r g a n i s a t i o n s . The response r a t e f o r CDHA members (78 per c e n t ) was more than t w i c e as h i g h than f o r non-members (36 per c e n t ) . Most r e s p o n d e n t s (7^ per c e n t ) l i v e d i n j u r i s d i c t i o n s where c o n t i n u i n g e d u c a t i o n i s not mandatory f o r d e n t a l h y g i e n i s t s . Only 18 per cent have e v e r a t t e n d e d a d i s c u s s i o n o r m e e t i n g on the t o p i c o f mandatory c o n t i n u i n g e d u c a t i o n . The average number o f c o n t i n u i n g e d u c a t i o n programs a t t e n d e d i n the p r e c e d i n g twelve months was 2 . 3 , but 28 per cent r e p o r t e d not h a v i n g a t t e n d e d any c o n t i n u i n g e d u c a t i o n programs d u r i n g t h a t p e r i o d . F i f t e e n per cent o f the re s p o n d e n t s have t a u g h t i n d e n t a l a u x i l i a r y t r a i n i n g programs, on e i t h e r a f u l l - o r p a r t - t i m e b a s i s . / MCE Score F i g u r e 1 showB the frequency d i s t r i b u t i o n o f the MCE Scores. Figure I. Frequency Distribution of M C E Scores 60 50 - 40 Uj 3 30 o Uj U_ 20 H 10 H 0 M C E SCORE 28. The average MCE Score was 6 l (S.D. = 1 1 ) . The score i n d i c a t e s the average respondent to be m i l d l y i n favour of mandatory c o n t i n u i n g e d u c a t i o n . The low standard d e v i a - t i o n I n d i c a t e s a f a i r degree of agreement among respondents. F a c t o r s t r u c t u r e of the MCE Scale In order to r e v e a l the p r i n c i p a l dimensions u n d e r l y i n g a t t i t u d e toward mandatory c o n t i n u i n g education, the t h i r t e e n MCE item scores were f a c t o r analysed w i t h orthogonal r o t a t i o n . The f i r s t three f a c t o r s accounted f o r 3 2 . 7 per cent, 10.7 per cent and 8 . 7 per cent of the t o t a l v a r i a n c e i n MCE Scores r e s p e c t i v e l y . The next f i v e f a c t o r s each accounted f o r f i v e per cent or more of the v a r i a n c e , and the remaining f i v e f a c t o r s ranged between 2 . 7 per cent and 4 . 2 per cent i n t h e i r a b i l i t y to account f o r the MCE v a r i a n c e . The f i r s t three f a c t o r s , a c c o u n t i n g f o r 52 per cent o f the v a r i a n c e were then r e t a i n e d , I n t e r p r e t e d and used i n subsequent a n a l y s e s . Table 1 shows the item-whole c o r r e l a t i o n s of the t h i r t e e n items of the MCE S c a l e , and t h e i r l o a d i n g s w i t h the f i r s t three f a c t o r s I d e n t i f i e d by Varimax r o t a t i o n . Table 1 Item-whole C o r r e l a t i o n s and O r t h o g o n a l l y Rotated F a c t o r Loadings f o r the MCE Scale Scale Item Item-whole C o r r e l a t i o n MCE Varimax F a c t o r I Rotated F a c t o r Matrix F a c t o r I I F a c t o r I I I 1 . 5 8 * - . 5 2 * .19 2 - . 3 1 .14 .19 .79* 3 .66 .73* - . 2 3 - .14 4 - . 5 4 - . 1 9 .65* .19 5 - . 4 6 -.04 .67* - . 0 8 6 - . 0 2 . 4 1 * .12 .22 7 - . 3 6 - . 1 7 - . 0 9 .70* 8 .62 .75* - . 1 7 - . 0 5 9 .62 . 6 6 * -.11 - . 3 1 10 - . 7 4 - . 5 1 * . 6 0 * .11 11 - . 4 7 - . 1 4 . 6 0 * - . 0 1 12 .48 . 6 3 * .12 .10 13 .62 .70* .26 .05 Variance accounted f o r 32.7$ 10 . 7 $ ' 8 .7$ Cumulative Variance 32.7$ 43 .4$ 52.1$ * Loadings > . 4 0 3U. W i t h one e x c e p t i o n (Item 6) a l l i t ems o f the s c a l e show r e a s o n a b l e c o r r e l a t i o n s (from .31 t o .75) w i t h the MCE S c o r e . T h i s means t h a t a l l i t e m s b u t one tended t o measure what the s c o r e as a whole measured. The h i g h l o a d i n g items and t h e i r l o a d i n g s f o r each o f the t h r e e p r i n c - i p a l f a c t o r s i d e n t i f i e d by Varimax r o t a t i o n a r e shown i n T a b l e 2. TABLE 2. H i g h L o a d i n g Items by F a c t o r Upon Which They Load ITEM F a c t o r I : P r o f e s s i o n a l Enhancement L o a d i n g 1. Continuing Education should be mandatory for a l l dental hygienists. .58 3. Prestige of Dental Hygiene w i l l grow under a system of mandatory con- tinuing education. .73 6. Under a system of mandatory continuing education, serving on a provin- c i a l or n a t i o n a l dental hygiene association executive should q u a l i f y as a form of continuing education. .41 8. Mandatory continuing education w i l l increase competence i n dental hygiene p r a c t i c e . .74 9. Mandatory continuing education for dental hygienists should be written into l e g i s l a t i o n , not j u s t i n bylaws governing dental hygiene p r a c t i c e . .66 10. Learning i s an i n t e r n a l , voluntary process, therefore, mandatory contin- uing education i s wrong i n p r i n c i p l e . - .51 13. If continuing education were mandatory, dental hygienists would apprec- ia t e t h e i r career more. .70 F a c t o r I I : V o l u n t a r i n e s s 1. Continuing education should be mandatory for a l l dental h y g i e n i s t s . - .52 4. Continuing education should not be mandatory for hygienists l i v i n g i n remote areas. .65 5. Continuing education should be mandatory only i f employers would be required to give time o f f with pay for continuing education. .67 11. Dental hygienists generally p a r t i c i p a t e i n enough continuing education to meet t h e i r need to remain abreast of developments. .60 10. Learning i s an i n t e r n a l , voluntary process, therefore mandatory contin- uing education i s wrong i n p r i n c i p l e . .60 F a c t o r I I I : Program C u r r e n t n e s s 2. Dental Hygienists who teach i n dental a u x i l i a r y programs should ba exempt from mandatory continuing education requirements. .79 7. Dental Hygienists who have graduated within three years should be exempt from mandatory continuing education requirements. .71 31 The g e n e r a l meaning of each of the three p r i n c i p a l dimensions u n d e r l y i n g a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n seems to be d i s c e r n i b l e . For F a c t o r I, the three highest l o a d i n g items i n d i c a t e a b e l i e f t h a t mandatory c o n t i n u i n g e d u c a t i o n w i l l i n c r e a s e the p r e s t i g e , competence, and a p p r e c i a t i o n o f d e n t a l hygiene as a p r o f e s s i o n . High s c o r i n g respondents on t h i s f a c t o r b e l i e v e that requirements f o r mandatory c o n t i n u i n g e d u c a t i o n should be i n t r o d u c e d i n l e g i s l a t i o n , and that c o n t i n u i n g e d u c a t i o n should be mandatory f o r a l l h y g i e n i s t s . They r e j e c t the premise that l e a r n i n g i s an I n t e r n a l , v o l u n t a r y process and t h e r e f o r e mandatory c o n t i n u i n g e d u c a t i o n i s wrong In p r i n c i p l e . These h y g i e n i s t s a l s o tend to f e e l t h a t s e r v i n g as an o f f i c e r In p r o f e s s i o n a l o r g a n i s a t i o n s should q u a l i f y as a form of c o n t i n u i n g education -. C o l l e c t i v e l y , these seven items i n d i c a t e a b e l i e f t h a t 'mandatory c o n t i n u i n g e d u c a t i o n can be a s t r o n g t o o l to promote the growth and development of d e n t a l hygiene as a p r o f e s s i o n . T h i s f a c t o r was l a b e l l e d P r o f e s s i o n a l Enhancement. P r o f e s s i o n a l Enhancement score accounts f o r 3 2 . 7 per cent In the v a r i a n c e of MCE Score. Since the p r o f e s s i o n of d e n t a l hygiene i s of f a i r l y r e c e n t e s t a b l i s h m e n t i n Canada and i s growing at a r a p i d r a t e , the f a c t t h a t P r o f e s s i o n a l Enhancement i s the most important f a c t o r i n a c c o u n t i n g f o r MCE Score v a r i a n c e i s i g n i f i c a n t . As d e n t a l h y g i e n i s t s i n c r e a s i n g l y p e r c e i v e themselves as p a r t of an emerging p r o f e s s i o n a l group, t h e i r a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n i s l i k e l y to be i n c r e a s i n g l y i n f l u e n c e d by t h e i r d e s i r e to enhance the p r e s t i g e and competence of t h e i r p r o f e s s i o n . High l o a d i n g items f o r F a c t o r I I were exemption from mandatory c o n t i n u i n g e d u c a t i o n requirements f o r h y g i e n i s t s l i v i n g i n remote areas, a b e l i e f t h a t h y g i e n i s t s a l r e a d y p a r t i c i p a t e i n enough c o n t i n u i n g e d u c a t i o n to meet t h e i r needs, requirement f o r time o f f w i t h pay i f c o n t i n u i n g e d u c a t i o n were to be mandatory, and a b e l i e f t h a t l e a r n i n g i s an i n t e r n a l v o l u n t a r y p r o c e s s . There was a negative r e l a t i o n s h i p between F a c t o r I I s c o r e s and the statement that c o n t i n u i n g e d u c a t i o n should be mandatory f o r a l l d e n t a l h y g i e n i s t s . These items r e l a t e to a b e l i e f t h a t c o n t i n u i n g e d u c a t i o n should be a v o l u n t a r y a c t i v i t y . F a c t o r I I was l a b e l l e d as " V o l u n t a r i n e s s " . V o l u n t a r i n e s s accounted f o r 10.7 per cent o f v a r i a n c e i n MCE Scores. The f a c t t h a t P r o f e s s i o n a l Enhancement and V o l u n t a r i n e s s are the two s t r o n g e s t u n d e r l y i n g dimensions of a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n exposes a p o s s i b l e source of ambivalence on the i s s u e : a h y g i e n l s t might b e l i e v e p h i l o s o p h i c a l l y that c o n t i n u i n g e d u c a t i o n should be v o l u n t a r y , yet a l s o p e r c e i v e i t to be a poten- t i a l l y powerful mechanism f o r the development and growth of the p r o f e s s i o n . 33. There were two items l o a d i n g h i g h l y on F a c t o r I I I . They were a b e l i e f i n exemption from mandatory c o n t i n u i n g edu- c a t i o n ' requirements f o r d e n t a l a u x i l i a r y educators, and a l s o f o r h y g i e n i s t s who had graduated w i t h i n three y e a r s . H y g i e n i s t s w i t h h i g h scores f o r t h i s f a c t o r o b v i o u s l y b e l i e v e that d e n t a l hygiene e d u c a t i o n programs are up to date i n t h e i r content, and producing graduates whose competence i s assured f o r at l e a s t a three year p e r i o d . F a c t o r I I I accounted f o r 8.7 per cent of the v a r i a n c e i n MCE Score, and was g i v e n the l a b e l Program Currentness. The f i r s t three o r t h o g o n a l f a c t o r s account f o r 52.1 per cent of the v a r i a n c e i n MCE Scores. T h i s f a c t , and the i d e n t i f i c a t i o n o f e i g h t o t h e r minor f a c t o r s suggest that a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n as measured by t h i s s c a l e appear to c o n t a i n s e v e r a l separate components r e p r e s e n t e d by groups of items on the s c a l e . T e s t i n g the Hypotheses The seven hypotheses were t e s t e d by examining r e l a t i o n - s h i p s between MCE Scores and scores f o r P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Currentness, and independent v a r i a b l e s a p p r o p r i a t e f o r each h y p o t h e s i s . The r e s u l t s are summarized i n Tables 3 to 9. The r e l a t i o n - s h i p s are shown as c o r r e l a t i o n s f o r i n t e r v a l data and dichotomous data, and as analyses of v a r i a n c e f o r nominal data. 3 4 . Hypothesis One: Dental h y g i e n i s t s who are "remote" i n terms of l i v i n g f a r t h e r from d e n t a l hygiene and d e n t a l schools and having graduated longer ago w i l l be l e s s f a v o r a b l y disposed toward mandatory c o n t i n u i n g e d u c a t i o n than h y g i e n i s t s who l i v e c l o s e r and have graduated more r e c e n t l y . The v a r i a b l e s chosen to o p e r a t i o n a l i z e "remoteness" were m i l e s from nearest d e n t a l hygiene s c h o o l , m i l e s from nearest d e n t a l s c h o o l , and years s i n c e g r a d u a t i o n . The r e l a t i o n s h i p of these v a r i a b l e s to MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Currentness i s shown i n Table 3 . Table 3 R e l a t i o n s h i p s Between MCE Scores, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program Currentness and "Remoteness" V a r i a b l e s Independent V a r i a b l e MCE C o r r e l a t i o n P r o f e s s i o n a l V o l u n t a r i - Enhancement ness Program Currentness M i l e s from d e n t a l hygiene sc h o o l . 1 3 * . 1 6 * * - . 1 3 * - . 0 6 M i l e s from d e n t a l f a c u l t y .01 - . 0 2 - . 0 2 . 0 0 Years s i n c e g r a d u a t i o n - . 0 1 - . 0 6 -.04 . 1 2 * n=304 * p < . 0 5 , **p < . 0 1 , ***p < . 0 0 1 35. P o s t - h i g h s c h o o l e d u c a t i o n r e q u i r e d f o r d e n t a l h y g i e n i s t s l n Canada i s two, or i n some p r o v i n c e s three years, l e a d i n g to a diploma or c e r t i f i c a t e . I t was expected t h a t the l o n g e r the time lapse from t h i s b a s i c p r e p a r a t i o n f o r p r a c t i c e , the l e s s f a v o r a b l e would be'the a t t i t u d e to mandatory c o n t i n u i n g e d u c a t i o n . S i m i l a r l y , because of d i f f i c u l t i e s of access to major sources of c o n t i n u i n g e d u c a t i o n , those l i v i n g f a r t h e r from schools of d e n t a l hygiene and f a c u l t i e s of d e n t i s t r y were expected to be l e s s i n f a v o r of mandatory c o n t i n u i n g e d u c a t i o n than those l i v i n g near the f a c i l i t i e s . D i stance from the nearest f a c u l t y of d e n t i s t r y showed no s i g n i f i c a n t c o r r e l a t i o n w i t h MCE Scores or any of the scores f o r the three p r i n c i p a l u n d e r l y i n g f a c t o r s . Distance from the nearest s c h o o l of d e n t a l hygiene was c o r r e l a t e d p o s i t i v e l y w i t h MCE Score (p <1.05). T h i s means h y g i e n i s t s l i v i n g f a r t h e r from a s c h o o l of d e n t a l hygiene were more l n favour of mandatory c o n t i n u i n g e d u c a t i o n , c o n t r a r y to e x p e c t a t i o n s . T h i s v a r i a b l e was a l s o s i g n i f i c a n t l y c o r r e l a t e d w i t h the score f o r P r o f e s s i o n a l Enhancement (F a c t o r I) (p C.Ol), I n d i c a t i n g that h y g i e n i s t s f a r t h e r from d e n t a l hygiene s c h o o l s were more l i k e l y to p e r c e i v e that mandatory c o n t i n u i n g e d u c a t i o n would i n c r e a s e p r o f e s s i o n a l 36. s t a t u s and competence. C o r r e l a t i o n s w i t h V o l u n t a r i n e s s (Fa c t o r II) are n e g a t i v e (p <..05)j h y g i e n i B t s l i v i n g f a r t h e r from a s c h o o l of d e n t a l hygiene are l e s s l i k e l y to endorse " v o l u n t a r i n e s s " i n c o n t i n u i n g e d u c a t i o n than those l i v i n g nearby. "Years s i n c e g r a d u a t i o n " d i d not c o r r e l a t e w i t h MCE Score, P r o f e s s i o n a l Enhancement or V o l u n t a r i n e s s , but was s i g n i f i c a n t l y a s s o c i a t e d w i t h Program Currentness, a b e l i e f i n the c u r r e n t n e s s of d e n t a l hygiene e d u c a t i o n (p <C .05). In other words, the l o n g e r the time s i n c e a h y g i e n i s t had graduated, the more l i k e l y she was to b e l i e v e i n the c u r r e n t n e s s of knowledge of d e n t a l hygiene educators and r e c e n t graduates. The c o r r e l a t i o n s noted, even though s t a t i s t i c a l l y s i g n i f i c a n t , were low, and even more important, i n a d i r e c t i o n o p p o s i t e to t h a t p r e d i c t e d by the h y p o t h e s i s . Hypothesis One was thus r e j e c t e d . Hypothesis Two: D e n t a l h y g i e n i s t s w i t h "high" l e v e l s o f e d u c a t i o n a l achievement w i l l be more f a v o r a b l y disposed toward mandatory c o n t i n u i n g e d u c a t i o n than those w i t h "low" l e v e l s of e d u c a t i o n a l achievement. Table 4 shows c o r r e l a t i o n s between l e v e l o f e d u c a t i o n a c h i e v e d and MCE Score and s c o r e s f o r P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program C u r r e n t n e s s . Table 4 Relationship Between MCE Score, Professional Enhancement, Voluntariness, Program Currentness and Educational Achievement Independent Variable MCE Correlation Professional Voluntariness Enhancement Program Currentness Level of education .04 .01 -.08 -.02 received n=304 *p < .05, **P <.01, ***p <.001 It was supposed that increased educational achievement would predispose hygienists to consider additional education to be of importance to hygienists, and therefore that i t should be mandatory. The r e s u l t s showed no s i g n i f i c a n t c o r r e l a t i o n between increased educational achievement and MCE Score, or any of the three p r i n c i p a l dimensions of attitude toward MCE. Attitude toward mandatory continuing education i s independent of the amount of formal education completed by Canadian dental hygienists. The hypothesis must be rejected. 3 8 . Hypothesis Three: Dental h y g i e n i s t s a c t i v e l y i n v o l v e d with p r o f e s s i o n a l o r g a n i s a t i o n s w i l l be more f a v o r a b l y disposed to mandatory c o n t i n u i n g e d u c a t i o n than h y g i e n i s t s l e s s a c t i v e l y i n v o l v e d . The v a r i a b l e s chosen to o p e r a t i o n a l i z e involvement w i t h p r o f e s s i o n a l o r g a n i s a t i o n s were CDHA membership, number of a s s o c i a t i o n meetings attended i n the l a s t twelve months, number of n a t i o n a l conventions attended i n the l a s t f i v e y e a r s , and a s c a l e o f o f f i c e s i n p r o v i n c i a l and n a t i o n a l o r g a n i s a t i o n s . The r e l a t i o n s h i p of these v a r i a b l e s to MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Currentness i s shown i n Table 5 . Table 5 R e l a t i o n s h i p Between MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program Currentness, and Involvement w i t h P r o f e s s i o n a l A s s o c i a t i o n s -Independent V a r i a b l e MCE P r o f e s s i o n a l Enhancement Correlation V o l u n t a r i n e s s Program Currentness CDHA membership . 1 9 * * * .14* - . 1 6 * * . 2 1 * * * Meetings a t t e n d e d . i n l a s t 12 months . 1 3 * . 1 2 * - . 1 3 * - . 0 7 N a t i o n a l conventions attended l a s t 5 years . 0 1 - . 0 1 . 0 2 . 0 1 O f f i c e s h e l d , prov. or n a t i o n a l a s s o c i a t i o n .14* .13* -.14* - . 1 0 n = 304 *p <. . 0 5 , **p < . 0 1 , ***p < . 0 0 1 3 9 . I t was expected t h a t h y g i e n i s t s more i n v o l v e d with the a c t i v i t i e s of t h e i r p r o f e s s i o n a l a s s o c i a t i o n s would be more i n favour o f mandatory c o n t i n u i n g e d u c a t i o n than l e s s I n v o l v e d h y g i e n i s t s . Moreover, i t was expected that the higher the o f f i c e h e l d , a c c o r d i n g to the s c a l e d e s c r i b e d i n Chapter 3, the more i n favour o f mandatory c o n t i n u i n g education the h y g i e n i s t would be. CDHA membership, attendance at p r o f e s s i o n a l meetings In the past twelve months, and scores on the " o f f i c e h e l d " s c a l e d i d show s i g n i f i c a n t p o s i t i v e c o r r e l a t i o n s w i t h MCE Scores (p - C . 0 0 1 , . 0 5 , and . 0 5 , r e s p e c t i v e l y ) . These three v a r i a b l e s were a l s o s i g n i f i c a n t l y and p o s i t i v e l y c o r r e l a t e d w i t h P r o f e s s i o n a l Enhancement, as d e f i n e d by F a c t o r I (p <£.05 i n each c a s e ) . These three v a r i a b l e s were a l l n e g a t i v e l y c o r r e l a t e d w i t h F a c t o r I I , or V o l u n t a r i n e s s i n c o n t i n u i n g e d u c a t i o n ( p ^ . , 0 5 ) . CDHA members d i f f e r e d from non members i n being more l i k e l y to b e l i e v e that r e c e n t graduates and teachers should not be exempt from MCE requirements ( F a c t o r I I I , Program Currentness, p -d.OOl). There was no s i g n i f i c a n t c o r r e l a t i o n between MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , or Program Current- ness, and the number of n a t i o n a l conventions attended i n the l a s t f i v e y e a r s . T h i s v a r i a b l e was c o n s i d e r e d to be a l e s s important measure of p r o f e s s i o n a l o r g a n i s a t i o n involvement than the o t h e r three, because attendance at n a t i o n a l meetings i s i n f l u e n c e d by cost of t r a v e l , g e t t i n g time o f f work, and s u c h l i k e . The r e s u l t s d e p i c t e d i n Table 5 support the hypothesis that i n c r e a s e d involvement i n p r o f e s s i o n a l o r g a n i s a t i o n s w i l l i n c r e a s e f a v o r a b l e n e s s toward mandatory c o n t i n u i n g e d u c a t i o n , and the h y p o t h e s i s i s accepted. Hypothesis Four: Dental h y g i e n i s t s who have p a r t i c i p a t e d more a c t i v e l y i n a c a r e e r i n d e n t a l hygiene w i l l be more f a v o r a b l y disposed to mandatory c o n t i n u i n g e d u c a t i o n than h y g i e n i s t s w i t h l e s s p a r t i c i p a t i o n i n a c a r e e r i n d e n t a l hygiene. The v a r i a b l e s chosen to o p e r a t i o n a l i z e p a r t i c i p a t i o n i n a c a r e e r l n d e n t a l hygiene were : years worked as a d e n t a l h y g i e n i s t ; per cent o f employed years worked f u l l time; c u r r e n t employment as a d e n t a l h y g i e n i s t ; hours of work per week i f c u r r e n t l y employed; t e a c h i n g experience; years of f u l l time t e a c h i n g ; and years of p a r t time t e a c h i n g . The r e l a t i o n s h i p of these v a r i a b l e s to MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Currentness are shown i n Table 6. 41. Table 6 Relationship Between MCE Score, Professional Enhancement, Voluntariness, Program Currentness, and Career P a r t i c i p a t i o n Independent Variable MCE Professional Enhancement Correlation Voluntariness Program Currentness Years worked as a dental hygienist - . 0 3 - . 0 6 - . 0 1 . 0 5 Per cent employed years worked f u l l time . 1 2 * . 1 4 * - . 1 2 * - . 0 3 Current employment i n dental hygiene - . 0 3 - . 0 6 .11 - . 0 8 Hours of work per week . 0 2 - . 0 1 .04 - . 0 9 Teaching experience . 0 6 . 0 6 -.08 . 0 1 Years f u l l time teaching .04 -.04 .00 .14* Years part time teaching . 0 5 - . 0 1 . 0 5 - . 0 5 n = 304 *p ^ . . 0 5 , **p ^ . 0 1 , ***p ^ . 0 0 1 4 2 . S i g n i f i c a n t r e l a t i o n s h i p s were found between the v a r i a b l e "per cent of employed years worked f u l l time" and MCE Score, P r o f e s s i o n a l Enhancement, and V o l u n t a r i n e s s . These c o r r e l a t i o n s were p o s i t i v e f o r MCE Score and Profess s i o n a l Enhancement and negative f o r V o l u n t a r i n e s s , a l l denoting i n c r e a s e d f a v o r a b l e n e s s toward mandatory c o n t i n u i n g e d u c a t i o n , a b e l i e f t h a t mandatory c o n t i n u i n g e d u c a t i o n w i l l enhance the p r e s t i g e and competence of d e n t a l hygiene, and a decrease i n the b e l i e f of v o l u n t a r i s m i n c o n t i n u i n g e d u c a t i o n , w i t h an i n c r e a s e i n the p o r t i o n of employed years b e i n g f u l l time. These c o r r e l a t i o n s were a l l s i g n i f i c a n t at the . 0 5 l e v e l . F a c t o r I I I , Program Currentness i n d e n t a l hygiene e d u c a t i o n , c o r r e l a t e d with number of years f u l l time t e a c h i n g at the . 0 5 l e v e l . The remaining v a r i a b l e s f a i l e d to show any s i g n i f i c a n t c o r r e l a t i o n w i t h any of the f o u r scores examined, however, and the weight of the data leads to the r e j e c t i o n of the h y p o t h e s i s . Hypothesis F i v e : Dental h y g i e n i s t s w i t h h i g h e r l e v e l s of p a r t i c i p a t i o n i n c o n t i n u i n g education w i l l be more f a v o r b a l y disposed toward mandatory c o n t i n u i n g e d u c a t i o n than h y g i e n i s t s w i t h lower c o n t i n u i n g e d u c a t i o n p a r t i c i p a t i o n l e v e l s . Increased p a r t i c i p a t i o n 'in c o n t i n u i n g e d u c a t i o n was o p e r a t i o n a l i z e d by two v a r i a b l e s : the number of c o n t i n u i n g e d u c a t i o n programs attended d u r i n g the past twelve months, and whether or not the respondent had ever presented a c o n t i n u i n g e d u c a t i o n program. The c o r r e l a t i o n s of these two v a r i a b l e s w i t h MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Currentness appear i n Table 7 . Table 7 R e l a t i o n s h i p Between MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program Currentness, and V a r i a b l e s f o r P a r t i c i p a t i o n i n C o n t i n u i n g E d u c a t i o n Independent MCE P r o f e s s i o n a l V o l u n t a r i n e s s Program V a r i a b l e s Enhancement Currentness C o n t i n u i n g e d u c a t i o n -programs . 1 6 * * . 1 3 * - . 1 7 * * - . 0 8 attended i n l a s t 1 2 months Pre s e n t e d a c o n t i n u i n g . 0 2 - . 0 3 - . 0 6 - . 0 2 e d u c a t i o n program n = 3 0 4 *p ^ . 0 5 , **p < C . 0 1 , **.*p - d . 0 0 1 4 4 . I t was a n t i c i p a t e d t h at the more c o n t i n u i n g e d u c a t i o n programs a h y g i e n i s t attended the more l i k e l y she was to f e e l t h a t a l l h y g i e n i s t s should a t t e n d such programs, and t h a t I t should be mandatory f o r h y g i e n i s t s to a t t e n d . The c o r r e l a t i o n s i n d i c a t e t h at the number of c o n t i n u i n g e d u c a t i o n programs attended i n the past twelve months i s a s s o c i a t e d w i t h i n c r e a s e i n o v e r a l l f a v o r a b l e n e s s toward mandatory c o n t i n u i n g e d u c a t i o n (p Z _ . O l ) , a b e l i e f t h a t I t i n c r e a s e s s t a t u s and competence f o r the p r o f e s s i o n (p <C»05)t a n<3 l e s s b e l i e f In the v o l u n t a r i n e s s of c o n t i n - uing e d u c a t i o n (p <C.Ol). The number of programs attended was not r e l a t e d to Program Currentness, the b e l i e f t h a t r e c e n t graduates and teachers should be exempt from mandatory c o n t i n u i n g e d u c a t i o n requirements. There was no c o r r e l a t i o n between p r e s e n t i n g a c o n t i n u i n g e d u c a t i o n program and scores f o r P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Currentness or f o r MCE Score. I t should be noted, however, that only 25 h y g i e n i s t s , or 8 .3 per cent of the t o t a l respondents r e p o r t e d having pre- sented such a program. The data tend to support the h y p o t h e s i s that i n c r e a s e d p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n i n c r e a s e s f a v o r a b l e n e s s toward mandatory c o n t i n u i n g . e d u c a t i o n , and the hypothesis i s accepted. 45. Hypothesis S i x ; Understanding the i s s u e s and involvement: w i t h mandatory c o n t i n u i n g e d u c a t i o n w i l l i n c r e a s e f a v o r a b l e n e s s toward mandatory c o n t i n u i n g e d u c a t i o n . The v a r i a b l e s used to t e s t t h i s h y p o thesis were attendance at a meeting or d i s c u s s i o n on the t o p i c of mandatory c o n t i n u i n g education, r e s i d e n c e i n a j u r i s d i c t i o n where c o n t i n u i n g e d u c a t i o n i s mandatory f o r h y g i e n i s t s , and r e s i d e n c e i n a j u r i s d i c t i o n where i t i s mandatory f o r d e n t i s t s . Table 8 shows the c o r r e l a t i o n s o f these v a r i a b l e s w i t h MCE Score and w i t h scores on P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Currentness. Table 8 R e l a t i o n s h i p Between MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , Program Currentness and V a r i a b l e s f o r Understanding o f and Involvement w i t h Mandatory C o n t i n u i n g E d u c a t i o n C^rTeTaTioiri Independent MCE P r o f e s s i o n a l V o l u n t a r i n e s s Program V a r i a b l e Enhancement Currentness \ Attended meeting or d i s c u s s i o n on t o p i c .09 .18** -.11 .01 L i v i n g where cont. ed. i s mandatory f o r h y g i e n i s t s .15** .15** - .21*** - . 0 4 L i v i n g where cont. ed. i s mandatory f o r d e n t i s t s .19*** .16** -.17** -.14*. n = 304 *p C .05, **p ^ .01, ***p .001 I t was supposed that the e x i s t e n c e of mandatory c o n t i n u i n g e d u c a t i o n i n the J u r i s d i c t i o n , f o r de n t a l h y g i e n i s t s or f o r d e n t i s t s , would predispose h y g i e n i s t s to be more i n f a v o r of mandatory c o n t i n u i n g education, because i t would r e p r e s e n t a d e c i s i o n of l e a d e r s of the p r o f e s s i o n s . S a n c t i o n i n g of the p r i n c i p l e by l e a d e r s would provide a model, and Induce a l i k e a t t i t u d e i n group members, as Kanekar ( 1 9 7 6 ) suggested. I t might a l s o provide rewards of s o c i a l approval from l e a d e r s to h y g i e n i s t s a l s o p r o f e s s i n g to be i n f a v o r of mandatory c o n t i n u i n g e d u c a t i o n , r e s u l t i n g i n operant c o n d i t i o n i n g as d e s c r i b e d by S t a a t s ( 1 9 6 7 ) , and Rhine ( 1 9 6 7 ) . Attendance at a meeting or d i s c u s s i o n on the t o p i c of mandatory c o n t i n u i n g education d i d not i n c r e a s e o v e r a l l MCE Score, nor d i d i t i n f l u e n c e scores f o r V o l u n t a r i n e s s and Program Currentness. But h y g i e n i s t s who had attended d i s c u s s i o n s d i d . p e r c e i v e mandatory c o n t i n u i n g e d u c a t i o n to enhance p r o f e s s i o n a l s t a t u s and competence more than h y g i e n i s t s who had not attended such a meeting. ( F a c t o r I, p <- . 0 1 ) . R e s i d i n g l n a J u r i s d i c t i o n where c o n t i n u i n g e d u c a t i o n i s mandatory f o r hygienl3ts and where i t i s mandatory f o r d e n t i s t s both s i g n i f i c a n t l y i n f l u e n c e a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n . S i g n i f i c a n t p o s i t i v e c o r r e l a t i o n s e x i s t between MCE Score and mandatory d e n t a l hygiene c o n t i n u i n g education (p <i_.01), and mandatory d e n t a l c o n t i n u i n g e d u c a t i o n (p <^.00l). Scores f o r P r o f e s s i o n a l Enhancement a l s o show s i g n i f i c a n t p o s i t i v e c o r r e l a t i o n s w i t h these two v a r i a b l e s (p ^~ .01 l n each c a s e ) , meaning that h y g i e n i s t s who l i v e where there i s mandatory c o n t i n u i n g e d u c a t i o n f o r h y g i e n i s t s or d e n t i s t s were more l i k e l y to see i t as enhancing the p r e s t i g e and competence of d e n t a l hygiene than d i d h y g i e n i s t s l i v i n g i n other a r e a s . C o r r e l a t i o n s between these two v a r i a b l e s and v o l u n t a r i n e s s were negative (p .001 and p <1 .01 r e s p e c t i v e l y ) . H y g i e n i s t s l i v i n g where c o n t i n u i n g e d u c a t i o n i s mandatory f o r hygienisfrs or d e n t i s t s were thus l e s s l i k e l y to p r o f e s s support f o r v o l u n t a r y c o n t i n u i n g e d u c a t i o n than h y g i e n i s t s l i v i n g elsewhere. H y g i e n i s t s l i v i n g i n J u r i s d i c t i o n s w i t h mandatory c o n t i n u i n g e d u c a t i o n f o r d e n t i s t s were more l i k e l y to deny exemption from mandatory c o n t i n u i n g e d u c a t i o n requirements f o r r e c e n t graduates and teachers ( F a c t o r I I I ) than were h y g i e n i s t s l i v i n g i n ot h e r areas. T h i s p a r t i c u l a r d i f f e r - e n t i a t i o n o f a t t i t u d e s d i d not hol d true f o r h y g i e n i s t s l i v i n g / n o t l i v i n g i n a J u r s i d i c t i o n w i t h mandated c o n t i n u i n g e d u c a t i o n f o r h y g i e n i s t s . 48. At the time of the survey (January 1979), B r i t i s h Columbia was the only province r e q u i r i n g c o n t i n u i n g e d u c a t i o n f o r h y g i e n i s t s , and the r e g u l a t i o n had only come i n t o f o r c e t h a t same month. The d i f f e r e n c e s i n a t t i t u d e f o r t h i s v a r i a b l e , t h e r e f o r e , r e f l e c t a response to the d e c i s i o n to implement mandatory c o n t i n u i n g educa- t i o n r a t h e r than a c t u a l experience with the requirement. Where they e x i s t , mandatory c o n t i n u i n g e d u c a t i o n requirements f o r d e n t i s t s are o f longer s t a n d i n g . D i f f e r e n c e s i n scores f o r h y g i e n i s t s l i v i n g i n these areas probably mean that h y g i e n i s t s p e r c e i v e the system to work w e l l f o r the d e n t a l p r o f e s s i o n . I t may a l s o r e p r e s e n t m o d e l l i n g , as noted ( e a r l i e r , by a p r o f e s s i o n a l group w i t h g r e a t e r s t a t u s and power. T h i s hypothesis attempted to deal w i t h two a s p e c t s : understanding of the. i s s u e , and involvement w i t h mandatory c o n t i n u i n g e d u c a t i o n . The data on the f i r s t aspect tend to be ambiguous, but on the second the r e l a t i o n s h i p s are e v i d e n t . The hypothesis t h e r e f o r e should be accepted In a m o d i f i e d form: Dental h y g i e n i s t s who have had experience w i t h mandatory c o n t i n u i n g e d u c a t i o n w i l l be more f a v o r a b l y d i s p o s e d toward i t than h y g i e n i s t s who have not had experience w i t h i t . 4 9 . Hypothesis Seven: Dental h y g i e n i s t s who are more c o n s e r v a t i v e i n o u t l o o k w i l l be more l i k e l y to f a v o r mandatory c o n t i n u i n g e d u c a t i o n than l e s s c o n s e r v a t i v e h y g i e n i s t s . The v a r i a b l e used to o p e r a t i o n a l i z e c o n s e r v a t i v e out- look was the Conservatism S c a l e devised by Wilson et a l (1973). As shown i n Table 9 , scores on t h i s s c a l e d i d not c o r r e l a t e w i t h any of the f a c t o r scores or w i t h the MCE s c o r e . Table 9 R e l a t i o n s h i p Between MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Currentness and Conservatism Score Independent V a r i a b l e MCE C o r r e l a t i o n P r o f e s s i o n a l V o l u n t a r i n e s s Enhancement Program Currentness Score on . . . .04 conservatism . 0 4 .03 - . 0 6 s c a l e n = 304 *p ^ 1 . 0 5 , **p ^ . 0 1 , ***p ^ . 0 0 1 I t may be that the t r a i t o f conservatism a c t u a l l y i n f l u e n c e s b o t h f o r and a g a i n s t f a v o r a b l e n e s s toward mandatory c o n t i n u i n g e d u c a t i o n . I f , as found by Hicks (1974) , conservatism c o r r e l a t e s w i t h a u t h o r i t a r i a n i s m , i t would tend to support f a v o r a b l e n e s s toward mandatory c o n t i n u i n g e d u c a t i o n . On the other hand, conservatism a l s o c o r r e l a t e s w i t h r e s i s t a n c e to change (Wilson, 1 9 7 3 ) . Since implementation o f mandatory c o n t i n u i n g e d u c a t i o n i n most areas would r e p r e s e n t a change, more c o n s e r v a t i v e h y g i e n i s t s might not be i n f a v o r . Thus conservatism and a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n may l i e i n an or t h o g o n a l r e l a t i o n s h i p to each o t h e r . In any case, the hypothesis that h y g i e n i s t s who are more c o n s e r v a t i v e i n o u t l o o k w i l l be more l i k e l y to f a v o r mandatory c o n t i n u i n g education was not supported. The hy p o t h e s i s was r e j e c t e d . A d d i t i o n a l demographic v a r i a b l e s In a d d i t i o n to the v a r i a b l e s used to t e s t the seven hypotheses, e i g h t a d d i t i o n a l demographic v a r i a b l e s were examined to determine t h e i r r e l a t i o n s h i p , i f any, to the MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Currentness. The r e s u l t s are presented i n Table 10. Table 10 Relationship Between MCE Score, Professional Enhancement, Voluntariness, Program Currentness and the Demographic Variables Independent Variable MCE Co r r e l a t i o n r (dichotomous i n t e r v a l data) Pr o f e s s i o n a l Voluntariness Program Enhancement Currentness MCE Analysis of Variance (E r a t i o ) (nominal data) Professional Voluntarines Program Enhancement Currentness sex marital status 1.67 1.61 1.39 1.55 number of children -.07 -.08 .01 .15** single parent status // age .06 f i e l d of employment x locus of program .02 size of community -.09 u -.08 .02 12* .01 .07 .09 15** ,12* .05 n = 304 * p /L .05, ** p < .01, *** p JC .001 // = c e l l numbers i n s u f f i c i e n t to conduct v a l i d analysis x = type of analysis not a p p l i c a b l e .80 99 1.32 1.60 C e l l numbers f o r two o f the v a r i a b l e s , sex, and s i n g l e p a r e n t s t a t u s , were i n s u f f i c i e n t to conduct a v a l i d a n a l y s i s . F o r the r e m a i n i n g v a r i a b l e s , t h e r e were no s i g n i f i c a n t l e v e l s o f c o r r e l a t i o n or a n a l y s i s o f v a r i a n c e w i t h MCE Score and V o l u n t a r i n e s s . P r o f e s s i o n a l Enhancement showed n e g a t i v e c o r r e l a t i o n w i t h s i z e o f community, i n d i c a t i n g t h a t the l a r g e r the community o f r e s i d e n c e , the l e s s l i k e l y h y g i e n i s t s were to l i n k MCE w i t h an i n c r e a s e i n p r o f e s s i o n a l p r e s t i g e and competence. Program C u r r e n t n e s s c o r r e l a t e d s i g n i f i c a n t l y w i t h t h r e e v a r i a b l e s . There was a p o s i t i v e c o r r e l a t i o n w i t h a S e (p ^ . 0 1 ) . A p o s i t i v e c o r r e l a t i o n was a l s o found w i t h number o f c h i l d r e n (p ^ , . 0 1 ) and l o c u s of program o f g r a d u a t i o n (p ^ . 0 5 ) , g r a d u a t e s from u n i v e r s i t y based programs b e i n g more l i k e l y t o s c o r e h i g h l y on Program C u r r e n t n e s s t h a n g r a d u a t e s of community c o l l e g e based programs. Program C u r r e n t n e s s d i d not c o r r e l a t e w i t h r m a r i t a l s t a t u s , f i e l d o f employment, or s i z e o f community o f r e s i d e n c e . From these r e s u l t s , i t i s apparent t h a t t h e s e a d d i t i o n a l demographic v a r i a b l e s do not a p p r e c i a b l y i n - f l u e n c e a t t i t u d e toward MCE. 53. Regression A n a l y s i s The apparent absence of powerful r e l a t i o n s h i p s between the three components of MCE Scores and the independent v a r i a b l e s , coupled w i t h the i n d u c t i v e nature of the i n v e s t i g a t i o n , , l e d to a d e c i s i o n to undertake a stepwise m u l t i p l e r e g r e s s i o n a n a l y s i s to determine which Independent v a r i a b l e s p r e d i c t a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n as o p e r a t l o n a l i z e d by MCE Score, P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , and Program Currentness. The r e s u l t s are r e p o r t e d i n Tables 11, 12, 13 and 14 r e s p e c t i v e l y . Table 11 Summary of R e g r e s s i o n Equation E f f e c t s of Independent V a r i a b l e s on MCE Score V a r i a b l e M u l t i p l e ( i n o r d e r of e n t r y ) R Cumulative 2 R Simple r Beta Cont. ed. mandatory f o r d e n t i s t s .19 .035 .19 .10 CDHA membership .25 .065 .19 .15 M i l e s from nearest d e n t a l hygiene s c h o o l .28 .081 .13 .14 Per cent of employed years worked f u l l time .31 .095 .14 .11 Attendance at p r o f e s s i o n a l meetings, l a s t 12 months .33 .107 .13 .10 Only f i v e v a r i a b l e s e n t e r e d the r e g r e s s i o n equation f o r MCE Score. Together, these e x p l a i n only 10.7 per cent o f the v a r i a n c e . The most powerful p r e d i c t o r s o f MCE Scores are mandatory c o n t i n u i n g e d u c a t i o n f o r d e n t i s t s ( 3 . 5 per c e n t ) , and membership i n CDHA ( 3 per c e n t ) . Three a d d i t i o n a l v a r i a b l e s , d i s t a n c e from the nearest s c h o o l of d e n t a l hygiene, per cent of employed years worked f u l l time, and number of p r o f e s s i o n a l meetings attended l n the past twelve months, each account f o r s l i g h t l y more than one per cent o f the v a r i a n c e . I t can be seen from these r e s u l t s t h at none of the v a r i a b l e s account f o r a s u b s t a n t i a l v a r i a n c e i n MCE Scores. Persons most l i k e l y to score h i g h l y on the MCE Sc a l e l i v e i n a j u r i s d i c t i o n where c o n t i n u i n g education i s mandatory f o r d e n t i s t s , are members of CDHA, l i v e f a r t h e r from the nearest s c h o o l o f d e n t a l hygiene than "low s c o r e r s " , have worked a g r e a t e r p r o p o r t i o n o f t h e i r employed years on a f u l l time b a s i s , and have attended more p r o f e s s i o n a l a s s o c i a t i o n meetings i n the past twelve months than have "low s c o r e r s " . A t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n has been shown to be m u l t i d i m e n s i o n a l i n nature. I t i s not s u r p r i s i n g t h e r e f o r e than an examination o f r e g r e s s i o n equations f o r the three p r i n c i p a l f a c t o r s r e v e a l s p r e d i c t o r v a r i a b l e s d i f f e r e n t from MCE Score. Table 12 Summary o f R e g r e s s i o n E q u a t i o n E f f e c t s o f Independent V a r i a b l e s on P r o f e s s i o n a l Enhancement V a r i a b l e M u l t i p l e C u m u l a t i v e Simple B e t a ( i n o r d e r 2 o f e n t r y ) R R r A t t e n d e d meeting .18 on t o p i c P e r cent o f employed y e a r s worked f u l l time .24 M i l e s from n e a r e s t dent. hyg. s c h o o l . 2 9 Cont. ed. mandatory f o r d e n t i s t s . 3 2 M i l e s from n e a r e s t f a c u l t y o f d e n t i s t r y .34 Attendance a t p r o f e s s i o n a l m e e t i n g s , l a s t 12 months . 3 6 ,034 ,058 ,083 ,100 ,114 127 . 1 8 .10 .16 .10 .17 . 1 9 .16 . 0 9 . 0 3 - . 1 5 .12 . 0 9 S i x independent v a r i a b l e s account f o r more th a n 1 per cent o f the v a r i a n c e i n P r o f e s s i o n a l Enhancement s c o r e ( F a c t o r I) w h i c h l i n k s mandatory c o n t i n u i n g e d u c a t i o n w i t h i n c r e a s e d s t a t u s and competence f o r the d e n t a l hygiene p r o - f e s s i o n . The most i n f l u e n t i a l o f t h e s e s i x v a r i a b l e s was attendance at a meeting or d i s c u s s i o n on the i s s u e , and i t accounted f o r 3.4 per cent of the v a r i a n c e i n F a c t o r I s c o r e s . Other v a r i a b l e s e x p l a i n i n g more than one per cent of the v a r i a n c e were, i n descending o r d e r , percentage o f employed years worked f u l l time, d i s t a n c e from nearest d e n t a l hygiene s c h o o l , l i v i n g i n a j u r i s d i c t i o n where c o n t i n u i n g e d u c a t i o n i s mandatory f o r d e n t i s t s , d i s t a n c e from the nearest f a c u l t y of d e n t i s t r y , and the number of p r o f e s s i o n a l meetings attended i n the past twelve months. In comparison w i t h h y g i e n i s t s showing low scores f o r P r o f e s s i o n a l Enhancement, h i g h s c o r e r s e x h i b i t e d the f o l l o w i n g c h a r a c t e r i s t i c s : they had attended a meeting or d i s c u s s i o n on the t o p i c of mandatory c o n t i n u i n g e d u c a t i o n had spent more of t h e i r employed years working f u l l time; l i v e d f a r t h e r from a s c h o o l o f d e n t a l hygiene; were more l i k e l y to l i v e i n an area where c o n t i n u i n g e d u c a t i o n i s mandatory f o r d e n t i s t s ; l i v e d c l o s e r to a f a c u l t y of d e n t i s t r y ; and had attended more p r o f e s s i o n a l meetings over the past twelve months, than low s c o r e r s . As was true f o r the MCE Score, the v a r i a b l e s i d e n t i f i e d as having the best p r e d i c t i v e power are not s t r o n g p r e d i c t o r The s i x v a r i a b l e s which each e x p l a i n one per cent or more 5 7 o f the v a r i a n c e i n P r o f e s s i o n a l Enhancement s c o r e s t o g e t h e r o n l y account f o r 1 2 . 7 per cent o f the t o t a l v a r i a n c e . T a b l e 13 Summary o f R e g r e s s i o n E q u a t i o n E f f e c t s o f Independent V a r i a b l e s on V o l u n t a r i n e s s V a r i a b l e M u l t i p l e C u m u l a t i v e Simple B e t a ( i n o r d e r 2 o f e n t r y ) R R r Cont. ed. mandatory f o r d e n t a l h y g i e n i s t s . 2 1 Attendance a t c o n t . ed. programs, l a s t 1 2 months . 2 7 S i z e o f community . 3 0 CDHA membership . 3 3 C u r r e n t employment as d e n t a l h y g i e n i s t . 3 5 Per cent o f employed y e a r s worked f u l l time . 3 6 Taught i n d e n t a l a u x i l i a r y program . 3 7 .044 -.21 -.19 .074 - . 8 1 -.19 .089 .10 .11 .107 - . 1 6 - . 1 3 .121 .11 .10 . 1 3 1 - . 1 3 - . 0 8 .140 .08 -.09 Seven independent v a r i a b l e s accounted f o r one per cent or more of the va r i a n c e i n V o l u n t a r i n e s s ; together they accounted f o r f o u r t e e n per cent o f the v a r i a n c e . L i v i n g i n a j u r i s d i c t i o n where c o n t i n u i n g e d u c a t i o n i s mandatory f o r d e n t a l h y g i e n i s t s was the most powerful p r e d i c t o r , a c c o u n t i n g f o r 4.4 per cent o f the v a r i a n c e . An a d d i t i o n a l 3 per cent of v a r i a n c e was accounted f o r by the number of c o n t i n u i n g e d u c a t i o n programs attended i n the l a s t twelve months. S i z e o f community, membership i n CDHA, c u r r e n t employment as a d e n t a l h y g i e n i s t , per cent o f employed years worked f u l l time, and t e a c h i n g experience i n a d e n t a l a u x i l i a r y program were the other v a r i a b l e s . H y g i e n i s t s who scored h i g h on V o l u n t a r i n e s s were, i n comparison with low s c o r e r s , l i v i n g i n an area where c o n t i n u i n g e d u c a t i o n i s not mandatory, attended fewer c o n t i n u i n g e d u c a t i o n programs i n the past twelve months, l i v e d i n a l a r g e r community, were not members of CDHA, were c u r r e n t l y employed as d e n t a l h y g i e n i s t s , had worked fewer o f t h e i r employed years on a f u l l time b a s i s , and have not taught i n a d e n t a l a u x i l i a r y program. 5 9 . Four independent v a r i a b l e s had p r e d i c t i v e power o f one per cent o r b e t t e r f o r s c o r e s on Program C u r r e n t n e s s , w h i c h a d v o c a t e s exemption from mandatory c o n t i n u i n g e d u c a t i o n r e q u i r e m e n t s f o r t e a c h e r s and r e c e n t g r a d u a t e s . A summary t a b l e f o r the r e g r e s s i o n e q u a t i o n f o r Program C u r r e n t n e s s i s p r e s e n t e d i n Table 14. Tab l e 14 Summary o f R e g r e s s i o n E q u a t i o n E f f e c t s o f Independent V a r i a b l e s on Program C u r r e n t n e s s V a r i a b l e ( i n o r d e r o f e n t r y ) M u l t i p l e C u m u l a t i v e Simple B e t a R R 2 r CDHA membership . 2 1 Years t e a c h i n g f u l l time . 2 5 Graduated from u n i v e r s i t y program .28 Cont. ed. mandatory f o r d e n t i s t s . 3 1 .042 .062 . 0 7 7 . 0 9 6 , 2 1 , 1 4 , 1 2 . 1 5 -.18 . 1 5 . 1 6 - . 1 3 60 Membership i n CDHA had the most p r e d i c t i v e power, ac c o u n t i n g f o r 4.2 per cent o f the v a r i a n c e . Three other v a r i a b l e s accounted f o r between one and two per cent of the v a r i a n c e each. These are years spent f u l l time t e a c h i n g , g r a d u a t i o n from a u n i v e r s i t y based d e n t a l hygiene program, and l i v i n g i n a j u r i s d i c t i o n w i t h mandatory con- t i n u i n g e d u c a t i o n f o r d e n t i s t s . In r e l a t i o n to respondents who had low F a c t o r I I I sco r e s , those b e l i e v i n g i n Program Currentness were l e s s l i k e l y to be members o f CDHA, i f they had t e a c h i n g experience they had spent fewer years i n f u l l time t e a c h i n g , had more l i k e l y graduated from a u n i v e r s i t y - b a s e d d e n t a l hygiene program than a community c o l l e g e program, and were l e s s l i k e l y to l i v e i n a j u r i s d i c t i o n where c o n t i n u i n g e d u c a t i o n i s mandatory f o r d e n t i s t s . However, together these f o u r v a r i a b l e s accounted f o r no more than 9.6 per cent of the var i a n c e i n F a c t o r I I I . I t i s noteworthy that no v a r i a b l e proved to be a very s t r o n g p r e d i c t o r f o r P r o f e s s i o n a l Enhancement, V o l u n t a r i n e s s , or Program Currentness. Even when a l l v a r i a b l e s c o n t r i b u t i n g one per cent or more to score v a r i a n c e are added together, the h i g h e s t amount of va r i a n c e t h a t c o u l d be e x p l a i n e d d i d not exceed 14 per cent ( i n V o l u n t a r i n e s s ) . T h i s r e s u l t i s not s u r p r i s i n g when i t i s remembered t h a t even when c o r r e l a t i o n s w i t h independent v a r i a b l e s and scores were s t a t i s t i c a l l y s i g n i f i c a n t , they were f a i r l y low. 61 I t i s e v i d e n t from the data a n a l y s i s t h a t not o n l y are a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n m u l t i d i m e n s i o n a l but that s o c i a l and demographic v a r i a b l e s expected on an a p r i o r i b a s i s to be s t r o n g p r e d i c t o r s of the a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n are not s t r o n g p r e d i c t o r s , e i t h e r of the o v e r a l l a t t i t u d e or of the three most prominent dimensions u n d e r l y i n g a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n . Chapter 5 C o n c l u s i o n s The f o l l o w i n g c o n c l u s i o n s are drawn from the data generated by t h i s survey: A t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n among Canadian d e n t a l h y g i e n i s t s are m u l t i d i m e n s i o n a l . The f i r s t three f a c t o r s ( a f t e r o rthogonal r o t a t i o n ) seem to lend themselves to the f o l l o w i n g l a b e l s : F a c t o r I, P r o f e s s i o n a l Enhancement. T h i s f a c t o r accounted f o r 3 2 . 7 per cent o f MCE Score v a r i a n c e . F a c t o r I I , V o l u n t a r i n e s s i n c o n t i n u i n g e d u c a t i o n . F a c t o r I I accounted f o r 1 0 . 7 per cent of the v a r i a n c e . F a c t o r I I I , Program Currentness. F a c t o r I I I accounted f o r 8 . 7 per cent o f v a r i a n c e i n MCE Scores. The mean MCE Score i n d i c a t e s t h a t respondents were s l i g h t l y i n f a v o r o f mandatory c o n t i n u i n g e d u c a t i o n . The standard d e v i a t i o n was low, meaning that there was not a wide v a r i a t i o n i n t o t a l s c o r e s . The r e s u l t s show t h a t a t t i t u d e to mandatory c o n t i n u i n g e d u c a t i o n was not s t r o n g l y a s s o c i a t e d w i t h s o c i a l and demo- gr a p h i c v a r i a b l e s , but the f o l l o w i n g v a r i a b l e s have some i n f l u e n c e : d i s t a n c e from the nearest school o f d e n t a l hygiene; CDHA membership; number of p r o f e s s i o n a l meetings attended i n the past twelve months; l e v e l o f o f f i c e h e l d i n p r o v i n c i a l and n a t i o n a l a s s o c i a t i o n s ; per cent o f employed years worked f u l l time; number of c o n t i n u i n g e d u c a t i o n programs attended i n the past twelve months; r e s i d e n c e i n a j u r i s d i c t i o n where c o n t i n u i n g e d u c a t i o n i s mandatory f o r d e n t i s t s ; r e s i d e n c e i n a j u r i s d i c t i o n where c o n t i n u i n g e d u c a t i o n i s mandatory f o r d e n t a l h y g i e n i s t s ; and locu s of program of g r a d u a t i o n i n d e n t a l hygiene. Approximately t e n per cent o f the v a r i a n c e i n a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n can be accounted f o r by the f i v e independent v a r i a b l e s , each e x p l a i n i n g one per cent or more of the MCE v a r i a n c e . These v a r i a b l e s a r e : l i v i n g i n a j u r i s d i c t i o n where c o n t i n u i n g e d u c a t i o n i s mandatory f o r d e n t i s t s ; membership i n CDHA; d i s t a n c e from the nearest s c h o o l o f d e n t a l hygiene; per cent o f employed years worked f u l l time; and the number of p r o f e s s i o n a l meetings attended i n the past twelve months. Six v a r i a b l e s , each having a p r e d i c t i v e power of one per cent or b e t t e r , accounted f o r 12.7 per cent o f the va r i a n c e i n P r o f e s s i o n a l Enhancement as d e f i n e d by F a c t o r I . 64 The v a r i a b l e s were: attendance at a d i s c u s s i o n on the i s s u e ; per cent o f employed years worked f u l l time; d i s t a n c e from the nearest s c h o o l of d e n t a l hygiene; l i v i n g where c o n t i n u i n g e d u c a t i o n i s mandatory f o r d e n t i s t s ; d i s t a n c e from the nearest f a c u l t y of d e n t i s t r y ; and the number of p r o f e s s i o n a l meetings attended i n the„ past twelve months. For V o l u n t a r i n e s s , as d e f i n e d as F a c t o r I I , seven v a r i a b l e s c o n t r i b u t e d one per cent or more to the e x p l a n a t i o n , o f v a r i a n c e , f o r a t o t a l o f f o u r t e e n per cent. The v a r i a b l e s were: l i v i n g where c o n t i n u i n g e d u c a t i o n i s mandatory f o r h y g i e n i s t s ; the number of c o n t i n u i n g e d u c a t i o n programs attended i n the past twelve months; s i z e o f community of r e s i d e n c e ; CDHA membershp; c u r r e n t employment as a den t a l h y g i e n i s t ; per cent o f employed years worked f u l l time; and t e a c h i n g i n a d e n t a l a u x i l i a r y program. Four v a r i a b l e s c o n t r i b u t e d one per cent or b e t t e r to the e x p l a n a t i o n of v a r i a n c e of scores f o r Program Currentness as d e f i n e d by F a c t o r I I I . Together they accounted f o r 9.6 per cent of the v a r i a n c e . The v a r i a b l e s were: CDHA member- sh i p ; years of f u l l time t e a c h i n g ; l o c u s of program of gr a d u a t i o n ; and l i v i n g where c o n t i n u i n g e d u c a t i o n i s manda- t o r y f o r d e n t i s t s . Only t h r e e o f the proposed seven hypotheses were su p p o r t These were H y p o t h e s i s Three: D e n t a l h y g i e n i s t s a c t i v e l y i n v o l v e d w i t h p r o f e s s i o n a l o r g a n i s a t i o n s w i l l be more f a v o u r a b l y d i s p o s e d t o mandatory c o n t i n u i n g e d u c a t i o n than h y g i e n i s t s l e s s a c t i v e l y I n v o l v e d , H y p o t h e s i s F i v e : D e n t a l h y g i e n i s t s w i t h h i g h e r l e v e l s o f p a r t i c i p a t i o n l n c o n t i n u i n g e d u c a t i o n w i l l be more f a v o u r a b l y d i s p o s e d toward mandatory c o n t i n u i n g e d u c a t i o n , and a m o d i f i e d H y p o t h e s i s S i x : H y g i e n i s t s who have had e x p e r i e n c e w i t h i t w i l l be more f a v o u r a b l y d i s p o s e d toward mandatory c o n t i n u i n g e d u c a t i o n than h y g i e n i s t s who have not had e x p e r i e n c e w i t h i t . The r e m a i n i n g h y p o t h e s e s , w h i c h m a i n t a i n e d t h a t f a v o r a b l e n e s s toward mandatory c o n t i n u i n g e d u c a t i o n would be d e c r e a s e d by remoteness from d e n t a l h y g i e n e e d u c a t i o n , and i n c r e a s e d by I n c r e a s e d e d u c a t i o n a l achievement, g r e a t e r c a r e e r p a r t i c i p a t i o n and more c o n s e r v a t i v e o u t l o o k were not s u p p o r t e d by the data and had to be r e j e c t e d . The a d d i t i o n a l demographic v a r i a b l e s o f age, m a r i t a l s t a t u s , number of c h i l d r e n , s i z e o f community o f r e s i d e n c e and f i e l d o f employment were not r e l a t e d t o a t t i t u d e t o w a r d mandatory c o n t i n u i n g e d u c a t i o n . 66. D i s c u s s i o n The m u l t i d i m e n s i o n a l n a t u r e o f a t t i t u d e s t o mandatory c o n t i n u i n g e d u c a t i o n i s c o n s i s t e n t w i t h i t s r e c e n t emergence as an I s s u e f o r h e a l t h p r o f e s s i o n a l s . The i s s u e i s a complex one, and i t i s l i k e l y t h a t a t t i t u d e s have not had s u f f i c i e n t time t o become w e l l e s t a b l i s h e d . Some o f the f a c t o r s making up the MCE s c o r e s c l e a r l y r e f l e c t arguments f o r o r a g a i n s t mandatory c o n t i n u i n g e d u c a t i o n . F o r example, mandatory c o n t i n u i n g e d u c a t i o n may be used as a t o o l t o develop the c o h e s i v e n e s s and t h e r e f o r e the power o f a p r o f e s s i o n a l group. I t can be r e g a r d e d as an i n s t r u m e n t t o enhance the p r e s t i g e , competence and a p p r e c i a t i o n f o r the a f f e c t e d p r o f e s s i o n . T h i s f e e l i n g I s r e f l e c t e d l n P r o f e s s i o n a l Enhancement. V o l u n t a r i n e s s , on the o t h e r hand, t a p s the c o n v i c t i o n t h a t c o n t i n u i n g e d u c a t i o n f o r h e a l t h p r o f e s s i o n a l s s h o u l d be e s s e n t i a l l y a v o l u n t a r y a c t i v i t y , engaged i n w i l l i n g l y because o f i t s i n t r i n s i c v a l u e , and i f unimpeded, h y g i e n i s t s w i l l v o l u n t a r i l y p a r t i c i p a t e i n as much c o n t i n u i n g e d u c a t i o n as they need. At p r e s e n t the combined r e s u l t o f the many dimensions o f a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n produces a mean a t t i t u d e s l i g h t l y i n f a v o r o f mandatory c o n t i n u i n g e d u c a t i o n , and w i t h l i t t l e v a r i a n c e i s s c o r e s , most s c o r e s b e i n g f a i r l y c l o s e t o the mean. F u t u r e e v e n t s and c i r c u m s t a n c e s may i n f l u e n c e these d i f f e r e n t dimensions o f a t t i t u d e u n e q u a l l y , p r o d u c i n g a s h i f t i n o v e r a l l a t t i t u d e , and a change i n the p r e d i c t i v e power o f one o r more o f the f a c t o r s . The development o f d e n t a l hygiene as a h e a l t h p r o f e s s i o n and the i n f l u e n c e o f j u r i s d i c t i o n s i n w h i c h c o n t i n u i n g e d u c a t i o n i s mandatory c o u l d produce a t t i t u d e s f a v o r i n g mandatory c o n t i n u i n g e d u c a t i o n . T h i s s h i f t w i l l be enhanced by the f a c t t h a t a t p r e s e n t , l e a d e r s i n the p r o f e s s i o n (as d e f i n e d by the l e v e l o f o f f i c e s h e l d ) a r e more l i k e l y t o f a v o r i t . There i s a t the same time a s m a l l but v o c a l and gr o w i n g group o f p r a c t i t i o n e r s and e x p e r t s i n c o n t i n u i n g e d u c a t i o n who decry the growth o f mandatory c o n t i n u i n g e d u c a t i o n , and who have been m o b i l i z i n g arguments and r e s o u r c e s t o combat the t r e n d ( O h l i g e r , 1979). T h e i r e f f o r t s have met w i t h some s u c c e s s to da t e , and i f the movement c o n t i n u e s t o grow i t c o u l d w e l l i n f l u e n c e a t t i t u d e s a g a i n s t mandatory c o n t i n u i n g e d u c a t i o n , at l e a s t f o r a s i g n i f i c a n t number of h e a l t h p r o f e s s i o n a l s . Such a phenomenon amongst Canadian d e n t a l h y g i e n i s t s c o u l d change the d i s t r i b u t i o n o f MCE s c o r e s t o a b i m o d a l d i s t r i b u t i o n , as opposed t o the p r e s e n t d i s t r i b u t i o n w hich has most s c o r e s c l u s t e r e d c l o s e to a s i n g l e mean. I t seems more p r o b a b l e , however, t h a t f o r s e e a b l e I n f l u e n c e s w i l l produce a d i s t r i b u t i o n o f 68, scores s i m i l a r to that at present but with a h i g h e r mean, i n d i c a t i n g I n c r e a s e d f a v o r a b l e n e s s toward mandatory c o n t i n u i n g e d u c a t i o n . The s a l i e n c e of d i f f e r e n t f a c t o r s i n the MCE Scale may change over time. T h i s i s p a r t i c u l a r l y t r u e i f p r o f e s s i o n a l enhancement, which at present accounts f o r more of the MCE Score v a r i a n c e than any other f a c t o r , becomes an important i s s u e f o r the d e n t a l hygiene p r o f e s s i o n i n Canada. Where mandatory c o n t i n u i n g e d u c a t i o n i s e s t a b l i s h e d / i n Canada, an important Issue w i l l be who i s to c o n t r o l d e c i s i o n s about how much and what kind of c o n t i n u i n g e d u c a t i o n i s r e q u i r e d . The body i n which these powers i s vested w i l l have a great deal of c o n t r o l over h y g i e n i s t s . W i l l h y g i e n i s t s themselves be empowered to make these d e c i s i o n s , or w i l l e d u c a t i o n be p r e s c r i b e d by d e n t i s t s ? Examination of the e f f e c t s of d i f f e r e n t independent v a r i a b l e s r e v e a l s some s o c i a l and demographic v a r i a b l e s which i n f l u e n c e a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n . These c o r r e l a t i o n s , however, tended to be low, and consequently r e g r e s s i o n equations showed that the v a r i a b l e s concerned e i t h e r s e p a r a t e l y or together account 6 9 . for a f a i r l y s m a l l p r o p o r t i o n of the va r i a n c e i n scores. T h i s i s to some extent an encouraging r e s u l t , s i n c e i t means that the issue has a b e t t e r chance of being decided upon i t s m e r i t s r a t h e r than being g r e a t l y i n f l u e n c e d by such v a r i a b l e s . The l a c k o f e i t h e r a p o s i t i v e or negative c o r r e l a t i o n between MCE Scores and conservatism scores i s s i m i l a r l y s i g n i f i c a n t , s i n c e i t means that h y g i e n i s t s are not pre- disposed by t h e i r p o s i t i o n on the p s y c h o l o g i c a l dimension of conservatism/liberaliBm to view the i s s u e i n a c e r t a i n way. T h i s may be because the i s s u e , being a f a i r l y r e c e n t one, i s s t i l l r e l a t i v e l y f r e e from i n f l u e n c e s r e l a t e d t o ge n e r a l p s y c h o l o g i c a l c h a r a c t e r i s t i c s . I t would be i n t e r e s t i n g to d i s c o v e r whether other i d e n t i f i e d p s y c h o l o g i c a l dimensions are s i m i l a r l y f r e e o f r e l a t i o n s h i p s to a t t i t u d e toward mandatory c o n t i n u i n g e d u c a t i o n . As time passes, some v a r i a b l e s may assume more i n f l u e n c e on a t t i t u d e s toward mandatory c o n t i n u i n g e d u c a t i o n than they have at pre s e n t . Experience w i t h mandatory c o n t i n u i n g edu- c a t i o n may or may not over the course o f s e v e r a l y e a r s , be p e r c e i v e d as s u c c e s s f u l by those h y g i e n i s t s a f f e c t e d . I f h y g i e n i s t s remote from d e n t a l hygiene s c h o o l s f i n d i t d i f f i c u l t to meet c o n t i n u i n g e d u c a t i o n requirements f o r l i c e n s u r e the present p o s i t i v e c o r r e l a t i o n between d i s t a n c e and f a v o r a b l e n e s s to mandatory c o n t i n u i n g e d u c a t i o n may be r e v e r s e d . These are but two examples o f the p o s s i b l e changes i n the i n f l u e n c e o f independent v a r i a b l e s i n the f u t u r e . V 70, F u t u r e R e s e a r c h P o s s i b i l i t i e s S e v e r a l f u r t h e r q u e s t i o n s f o r p o s s i b l e r e s e a r c h f l o w f r o m t h i s s t u d y : 1. W i l l t h e o v e r a l l a t t i t u d e o f C a n a d i a n d e n t a l h y g i e n i s t s t o w a r d s m a n d a t o r y c o n t i n u i n g e d u c a t i o n change f r o m i t s p r e s e n t " m i l d l y i n f a v o r " p o s i t i o n ? 2. W i l l t h e m u l t i d i m e n s i o n a l n a t u r e o f t h e a t t i t u d e e v o l v e o v e r t i m e t o become more u n i d i m e n s i o n a l ? W h i c h o f t h e i d e n t i f i e d i n d e p e n d e n t v a r i a b l e s w i l l assume more p r e d i c t i v e p o w e r s ? W i l l new f a c t o r g r o u p i n g s o f t h e MCE S c a l e emerge? 3. As h y g i e n i s t s i n some p r o v i n c e s e x p e r i e n c e m a n d a t o r y c o n t i n u i n g e d u c a t i o n how w i l l t h i s a f f e c t t h e i r a t t i t u d e t o w a r d i t ? W i l l i t change t h e i r p r e s e n t p e r c e p t i o n o f m a n d a t o r y c o n t i n u i n g e d u c a t i o n as a t o o l t o i n c r e a s e t h e s t a t u s o f t h e p r o f e s s i o n and the competence o f i n d i v i d u a l members? 4„ Does a t t i t u d e t o w a r d m a n d a t o r y c o n t i n u i n g e d u c a t i o n c o r r e l a t e w i t h measures o f p e r s o n a l i t y d i m e n s i o n s o t h e r t h a n c o n s e r v a t i s m ? 5 . Over t i m e , and e s p e c i a l l y i n j u r i s d i c t i o n s where c o n - t i n u i n g e d u c a t i o n f o r h y g i e n i s t s i s m a n d a t o r y , w i l l any o f t h e s o c i a l and d e m o g r a p h i c v a r i a b l e s t e s t e d i n c r e a s e i n t h e i r power t o p r e d i c t a t t i t u d e t o w a r d m a n d a t o r y c o n t i n u i n g e d u c a t i o n ? 71 6. What independent v a r i a b l e s are s i g n i f i c a n t l y r e l a t e d to mandatory c o n t i n u i n g e d u c a t i o n a t t i t u d e s ? 7. Where c o n t i n u i n g e d u c a t i o n i s mandatory, what p r o p o r t i o n o f r e q u i r e d c o n t i n u i n g e d u c a t i o n i s d i r e c t l y r e l a t e d to en s u r i n g competence, and how s u c c e s s f u l are these e f f o r t s ? The i s s u e o f mandatory c o n t i n u i n g e d u c a t i o n i s s t i l l a r e l a t i v e l y new one f o r Canadian d e n t a l h y g i e n i s t s . I t s r a m i f i c a t i o n s have not been f u l l y e x p l o r e d i n most p r o v i n c e s , perhaps even i n those p r o v i n c e s where h y g i e n i s t s are o f f i c i a l l y on r e c o r d as being i n f a v o r or opposed. I t i s , however, an i s s u e of gre a t importance. D e c i s i o n s and developments r e l a t i n g to i t w i l l have f a r - r e a c h i n g i m p l i c a t i o n s f o r h y g i e n i s t s i n d i v i d u a l l y and c o l l e c t i v e l y as a h e a l t h p r o f e s s i o n . REFERENCES American Dental A s s o c i a t i o n . Continuing Dental E d u c a t i o n Requirements. Chicago:American Dental A s s o c i a t i o n 1 9 7 8 . American Dental A s s o c i a t i o n . Dental Hygiene L i c e n s u r e . Chicago:American Dental A s s o c i a t i o n 1 9 7 9 . American Dental H y g i e n i s t s ' A s s o c i a t i o n . Report o f the E d u c a t i o n Committee, 1940. J o u r n a l o f the American Dental H y g i e n i s t s ' A s s o c i a t i o n , 1 9 4 1 , 1 5 ( 2 ) , 8 6 - 9 0 . A l l p o r t , G.W. A t t i t u d e s i n Handbook of S o c i a l Psychology Ed. C. Murchison, Worcester:Clark U n i v e r s i t y Press, 1 9 3 5 . B r i t i s h Columbia Dental H y g i e n i s t s A s s o c i a t i o n , BCDHA News- l e t t e r , January 1 9 7 9 . Bauer, J.C. & Bush, R.G. D e n t i s t s ' a t t i t u d e s toward con- t i n u i n g d e n t a l e d u c a t i o n : nontopic f a c t o r s of demand f o r c o urses. J o u r n a l of Dental Education, 1 9 7 8 , 42 ( l l ) , 623-626. C a f f e r a t a , G.L., Goldberg, H.J.V., Roghmann, K., & Fox, R. Con t i n u i n g e d u c a t i o n : a t t i t u d e s , i n t e r e s t s . a n d experiences o f p r a c t i c i n g d e n t i s t s . J o u r n a l of Dental E d u c a t i o n , 1 9 7 5 , 3 9 ( 1 2 ) , 7 9 3 - 8 0 0 . C a r t w r i g h t , C.B., & K e e v i l , J.M. C o n t i n u i n g e d u c a t i o n p r e f - erences o f Michigan d e n t i s t s and d e n t a l h y g i e n i s t s . J o u r n a l o f the Michigan Dental A s s o c i a t i o n , 1 9 7 6 , 5 8 ( 1 2 ) , 6 1 3 - 6 1 8 . 73". Comrey, A.L. & Newmeyer, J.A. Measurement of r a d i c a l i s m - conservatism. J o u r n a l o f S o c i a l Psychology, 1965, 67, 3 5 7 - 3 6 9 . D e r b y s h i r e , R.C. R e l i c e n s u r e , mandatory c o n t i n u i n g e d u c a t i o n , and the s t a t e r e g u l a t o r y agency. Proceedings: Mandatory C o n t i n u i n g E d u c a t i o n , Prospects and Dilemmas f o r P r o f e s s i o n a l s . D.E. Moore, Ed. U n i v e r s i t y o f I l l i n o i s , Urbana Champaign, Feb. 1976. Eysenck, H.J. The s t r u c t u r e o f human p e r s o n a l i t y . London: Methuen, i 9 6 0 . Gaughran, E., S t r e u n i n g , E., Raabe, G., & Muhlin, G.A. A f a c t o r a n a l y t i c study o f a t t i t u d e s toward human f e r t i l i t y . Adult Education, 1976, 2 6 ( 2 ) , 8 6 - 1 0 0 . H a l l o r a n , J.D. A t t i t u d e f o r m a t i o n and change. L e i c e s t e r U n i v e r s i t y Press, 1970. H i c k s , J.M. Cons e r v a t i v e v o t i n g and p e r s o n a l i t y . S o c i a l Behavior and P e r s o n a l i t y , 1974, 2 ( l ) , 4 3 - 4 9 . Houle, C.O. Evidence f o r the e f f e c t i v e n e s s o f c o n t i n u i n g p r o f e s s i o n a l e d u c a t i o n and the impact o f mandatory c o n t i n u i n g e d u c a t i o n . P r o c e d i n g s : Mandatory C o n t i n u i n g E d u c a t i o n : Prospects and Dilemmas f o r P r o f e s s i o n a l s . D.E. Moore, J r . , Ed. U n i v e r s i t y of I l l i n o i s , Urbana, Champaign, Feb. 1976. 74. Kanekar, S. O b s e r v a t i o n a l l e a r n i n g of a t t i t u d e s : a b e h a v i o r a l a n a l y s i s . European J o u r n a l o f S o c i o l o g i c a l Psychology, 1976, 6(1), 5 - 2 4 . Katz, D. The f u n c t i o n a l approach to the study o f a t t i t u d e s . P u b l i c O p i n i o n Quarterly, 11960, 2 4 , 163-204. K e e v i l , J.M. & Ca r t w r i g h t , C.B. Dental h y g i e n i s t s ' p r e f e r e n c e s f o r c o n t i n u i n g e d u c a t i o n e x p e r i e n c e s . Dental Hygiene, 1978, 5 2 ( 3 ) , 123-127. K l i n e , C. P a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n by employed d e n t a l h y g i e n i s t s i n B r i t i s h C o l u b l a . M.A. T h e s i s , Adult E d u c a t i o n Research Centre, U n i v e r s i t y o f B r i t i s h Columbia, 1975. Kubat, J . C o r r e l a t e s o f p r o f e s s i o n a l o b s o l e s c e n c e : p a r t 1 J o u r n a l o f Continuing,, E d u c a t i o n i n Nursing, 1975, 6 ( 6 ) , 2 2 - 2 9 . Lewis, C.E., & Hassanein, R.S. C o n t i n u i n g medical e d u c a t i o n - an e p i d e m i o l o g i c a l e v a l u a t i o n . New England J o u r n a l o f Medicine, 1970, 28 ( 2 ) , 2 5 4 - 2 5 9 . M a l v i t z , D.M. & Judge, S.P. C o r r e l a t e s o f r e p o r t e d p a r t i c - i p a t i o n i n c o n t i n u i n g e d u c a t i o n . Dental Hygiene, 1976, 5 0 ( 1 2 ) , 543-546. 75.. Nakamoto, J . , & Verner, C. C o n t i n u i n g e d u c a t i o n i n d e n t i s t r y a review of North Americal l i t e r a t u r e 1960-1970. Adult E d u c a t i o n Research Centre and D i v i s i o n of C o n t i n u i n g E d u c a t i o n i n the H e a l t h S c i e n c e s , U n i v e r s i t y of B r i t i s h Columbia, 1972. Neylan, M.S. L i t e r a t u r e review: m a i n t a i n i n g the competence of h e a l t h p r o f e s s i o n a l s 1970-1973. U n i v e r s i t y of B r i t i s h Columbia D i v i s i o n o f C o n t i n u i n g E d u c a t i o n i n the H e a l t h S c i e n c e s , 1974. Pearlman, S. Mandated c o n t i n u i n g e d u c a t i o n : weathervane f o r the l i f e t i m e of the p r o f e s s i o n a l ? I n t e r n a t i o n a l J o u r n a l of C o n t i n u i n g E d u c a t i o n and T r a i n i n g , 1974, 3(3-4), 185-191. Reagan, D.T., & F a z i o , R. On the c o n s i s t e n c y between a t t i t u d e s and b e h a v i o r : l o o k to the method o f a t t i t u d e f o r m a t i o n . J o u r n a l of Experimental S o c i a l Psychology, 1977, 13(l), 28-45. Rhine, R.J. A concept-formation approach to a t t i t u d e a c q u i s i t i o n . I n Readings i n a t t i t u d e theory and measurement, M. F i s h b e i n , Ed. New York, London, Sydney: John Wiley & Sons, Inc., 1 9 6 7 , 382-388. Rokeach, M. The Open and C l o s e d Mind, New York:Baslc books, I960. 76. Rokeach, M. B e l i e f s , a t t i t u d e s and v a l u e s 0 San F r a n c i s c o : Jossey-Bass, 1968. Rosenberg, M.T. C o g n i t i v e s t r u c t u r e and a t t i t u d e a f f e c t . J o u r n a l of Abnormal and S o c i a l Psychology, 1 9 5 6 , (53), 367-372. S c h a e f f e r , N., Widelock, D., & May, P.S. The c l i n i c a l l a b o r a t o r y program i n New York C i t y I I : progress a f t e r f i v e years of e x p e r i e n c e . H e a l t h Laboratory S c i e n c e s , 1979, 7, 242-255. Singh, A. S t r u c t u r e of s o c i a l a t t i t u d e s : a Canadian sample. P s y c h o l o g i c a l Reports, 1977, 4o(l), I65-I66. Snyder, D.T. & Schalgemeir, W.L. The Michigan d e n t i s t s and h i s c o n t i n u i n g e d u c a t i o n : Part I Background c h a r a c t e r - i s t i c s and f i r s t f i n d i n g s . J o u r n a l of the Michigan Dental A s s o c i a t i o n , 1973, 5_5, 312-316. S t a a t s , A.W. An o u t l i n e of an I n t e g r a t e d l e a r n i n g theory of a t t i t u d e f o r m a t i o n and f u n c t i o n . In Readings i n a t t i t u d e theory and measurement. M. F i s h b e i n , Ed. New York, London, Sidney: John Wiley & Sons Inc., 1967, 373-381. S t r o t h e r , G.B., & Swinford, D.N. R e c e r t i f i c a t i o n and r e l i c e n s u r e - i m p l i c a t i o n s f o r the u n i v e r s i t y . N a t i o n a l U n i v e r s i t y E x t e n s i o n A s s o c i a t i o n , S p e c t a t o r , !975, 39(19), 5-9. S t u a r t , C.T. Mandatory c o n t i n u i n g education f o r r e l i c e n s u r e i n n u r s i n g , and the i m p l i c a t i o n s f o r high e r e d u c a t i o n . J o u r n a l o f Co n t i n u i n g E d u c a t i o n i n Nursing, 1 9 7 5 , 6 ( 5 ) , 5 - 1 7 . T r l a n d i s , H.C. A t t i t u d e and a t t i t u d e change. New York, Wiley, 1 9 7 1 . Wilson, Q.D., Ed. The Psychology of Conservatism. London: Academic Press, 1 9 7 3 . Woodmansee, J . J . , & Cook, S.W. Dimensions of v e r b a l r a c i a l a t t i t u d e s : t h e i r i d e n t i f i c a t i o n and measurements. J o u r n a l o f P e r s o n a l i t y and S o c i a l Psychology, 1 9 6 7 , 7 , 2 4 0 - 2 5 0 . APPENDIX A 78. DENTAL HYGIENE — MANDATORY CONTINUING EDUCATION PART ONE PLEASE INDICATE THE EXTENT OF YOUR AGREEMENT OR DISAGREEMENT BY CIRCLING THE APPRO- PRIATE RESPONSE TO THE FOLLOWING STATEMENTS. BE FRANK - THERE ARE NO "CORRECT" ANSWERS. 1. Continuing education should be mandatory for all dental hygienists. L I L strongly moderately mildly neutral mildly moderately strongly, disagree disagree disagree agree agree agree Dental hygienists who teach in dental auxiliary programs should be exempt from mandatory continuing educa- tion requirements. I 1 L__ _ J J _ I I strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree 3. Prestige of Dental Hygiene will grow under a system of mandatory continuing education. I J I I I L strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree 4. Continuing education should not be mandatory for hygienists living in remote areas. strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree 5. Continuing education should be mandatory only if employers would be required to give time off with pay for continuing education. L 1 1 J 1 | | strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree Under a system of mandatory continuing education, serving on a provincial or national dental hygiene associa- tion executive should quality as a form of continuing education. strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree Please turn to Page 2. 779., 7. Dental hygienists who have graduated within three years should be exempt from mandatory continuing educa- tion requirements. I I J I _ _ l I I strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree t Mandatory continuing education will increase competence in dental hygiene practice. 1 strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree 9. Mandatory continuing education for dental hygienists should be written into legislation, not just in by-laws governing dental hygiene practice. I I I I I I I strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree 10. Learning is an internal, voluntary process, therefore mandatory continuing education is wrong in principle. I 1 .1 1 L_ I I strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree 11. Dental hygienists generally participate in enough continuing education to meet their need to remain abreast of developments. I L I i i _ L : i strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree 12. Where it has been tried out, mandatory continuing education works well. I J I L strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree 13. If continuing education were mandatory, dental hygienists would appreciate their career more. I I 1 _ I J I . I strongly moderately mildly neutral mildly moderately strongly disagree disagree disagree agree agree agree Please turn to Page 3. PART TWO P L E A S E A N S W E R E V E R Y Q U E S T I O N '86: 1. What is your age? 2. Sex DM DF 3. What is your marital status? D single D separated D married D widowed • divorced D cohabiting with other than spouse 4. How many children do you have? 5. Are you a single parent? D Yes Q No 6. Please indicate the size of the community in which you live. • less than 10,000 • 250,000-500,000 • 10,000-50.999 • 500,000-750,000 • 50,000-100,000 • 750,000-1,000,000 • 100,000-250,000 • More than 1,000,000 7. How many miles do you live from a) the nearest School of Dental Hygiene b) the nearest Faculty of Dentistry 8. What program (School) in Dental Hygiene did you graduate from? 9. In what year did you graduate? (If a student, in what year do you expect to graduate?) 10. a) For how many years have you worked as a dental hygienist? b) Of those years, what percentage of the time was: full time % part time % TOTAL 100 % 11. Are you now employed as a dental hygienist? • No • Yes If yes; a) for how many hours a week hrs. b) please check primary field of employment • private practice public health D clinic or hospital • dental auxiliary education other (please specify) 12. Are you a member of CD.H.A.? • Yes D N O 13. How many dental hygiene association meetings (society, provincial, or national) have you attended in the last twelve months? (Please specify a number) 14. How many national Dental Hygiene conventions have you attended in the last 5 years? • 0 D i D 2 D 3 L U D5 15. Please indicate by checking the box if you have held any of the following positions: • None of the positions held Provincial committee member National committee member Provincial committee chairman Provincial executive member • National committee • C.D.H.A. Board member • National Executive member 16. a) Is continuing education mandatory in your province for dental hygienists? • Yes • No • Don't know b) Is continuing education mandatory for dentists? • Yes • No • Don't know 17. Have you ever attended a presentation or dis- cussion meeting on the topic of mandatory continuing education? • Yes • No 18. How many continuing dental hygiene education programs have you attended in the last 12 months? (Include lectures, workshops, scientific sessions at conventions, study clubs, in-service programs, conferences, short courses.) (Please specify a number.) 19. Have you ever presented a continuing education program for dental hygienists or dental assistants? • Yes • No 20. Check the level of education you have attained diploma in dental hygiene • diploma in dental hygiene plus one or more additional courses credited toward a university degree D diploma in dental hygiene plus baccalaureate degree • diploma in dental hygiene plus masters degree 21. Have you ever taught in a dental auxiliary educa- tion program? • Yes D No If yes: • part time (no. of years) D full time (no. of years) Please turn to Page 4. PART III W H I C H O F T H E F O L L O W I N G D O Y O U F A V O U R O R B E L I E V E IN? (Circle " Y e s " or "No " . If absolutely uncertain, circle "?". There are no right or wrong answers; do not discuss; just give your first reaction. Answer all items.) 1 death penalty Ye s ? No 2 evolution theory Y e s ? No 3 school uniforms Ye s ? No 4 striptease shows Y e s ? No 5 Sabbath observance Ye s ? No 6 hippies Y e s ? No 7 patriotism Ye s ? No 8 . modern art Ye s ? No 9 self-denial Ye s ? No 10 working mothers Ye s ? No 11 miracles Yes ? No 12 birth control Yes ? No 13 military drill Yes ? No 14 co-education Ye s ? No 15 Divine law Ye s ? No 16 socialism Ye s ? No 17 white superiority Yes ? No 18 cousin marriage Yes ? No 19 moral training Yes ? No 20 suicide Ye s ? No 20 chaperones Ye s ? No 22 legalised abortion Yes ? No 23 empire-building Yes ? No 24 student pranks Yes ? No 25 licensing laws Yes ? No 26 computer music Y e s ? No 27 chastity Ye s ? No 28 fluoridation Ye s ? No 29 royalty Y e s ? No 30 women judges Ye s ? No 31 conventional clothing Ye s ? No 32 teenage drivers Ye s ? No 33 racial segregation Ye s ? No 34 pornography Ye s ? No 3 5 church authority Yes ? No 3 6 disarmament Yes ? No 37 censorship Ye s ? No 38 white lies Ye s ? No 39 corporal punishment Ye s ? No 4 0 mixed marriage Ye s ? No 41 strict rules Ye s ? No 42 jazz Yes ? No 43 straitjackets Yes ? No 44 casual living Ye s ? No 45 learning Latin Yes ? No 46 easy divorce Yes ? No 47 inborn consc ience Yes ? No 48 coloured immigration Yes ? No 49 Bible truth Yes ? No 50 smoking pot Yes ? No

Cite

Citation Scheme:

    

Usage Statistics

Country Views Downloads
United States 5 0
Russia 1 0
China 1 12
Japan 1 0
City Views Downloads
Unknown 5 0
Tokyo 1 0
Beijing 1 0
Ashburn 1 0

{[{ mDataHeader[type] }]} {[{ month[type] }]} {[{ tData[type] }]}

Share

Share to:

Comment

Related Items