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UBC Theses and Dissertations

Impact of a regulatory quality assurance program : perceptions of dental hygienists in British Columbia Soth, Monica


Dental hygienists in British Columbia must participate in a Quality Assurance Program (QAP) to support their professional competence. The College of Dental Hygienists of British Columbia launched a new quality assurance program in 2013 and has now enrolled all practicing registrants into the program. This study explored dental hygienists’ perceptions of the QAP from the perspective of its impact on practice. Based on a critical realism framework, this mixed methods study used a quantitative component nested within a predominantly qualitative design. The study employed an exploratory sequential design in which participants completed an online survey with some participating in telephone interviews. The online survey (n=451; 12.7% response rate) collected data regarding perceptions of practitioners and the impact of the program related to safe and competent care. It included quantitative data about potential barriers to implementing regulatory standards, conditions of work, and professional identity along with qualitative data from open-ended questions. Phase 2 involved 11 respondent interviews to gain a deeper understanding of the impact of the program on care. Analysis of the data sets revealed several themes. Respondents discussed how the regulatory practice standards, a key component of the QAP quality assurance program, related to patient safety, competence, professional agency, autonomy, and professional confidence within the current workplace culture. Respondents viewed themselves as healthcare professionals. They generally felt valued for their abilities and enjoyed maintaining currency through continuing education activities. They revealed that the QAP generally had little influence on the delivery of care. The business culture within dental offices appeared to negatively affect participants’ professional agency thus affecting their ability to implement their regulatory practice standards. Failure to implement these standards may negatively affect client safety and result in reduced health outcomes. This study will be of interest to healthcare regulatory bodies and others in the profession.

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