Dental Hygienist Quality Assurance Program

In accordance with the Health Professions Act, all B.C. health professions must establish a Quality Assurance Program (QAP). 

Quality Assurance Project Update

BCCOHP is working to establish a modernized quality assurance program for all oral health professionals. This is a key initiative and is expected to be a multi-year project.

The quality assurance programs developed by the legacy colleges that came together to form BCCOHP remained in place upon amalgamation and are currently under review. These will remain in force until a new quality assurance program is developed.

Stay informed about the progress here >>

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The QAP Assessment Tool is an online, assessment tool that is to be completed by all registrants once every five years. It was designed specifically to meet the requirement under the Health Professions Act for an assessment of registrants’ practice quality, as well as to provide useful feedback to registrants regarding their current knowledge of foundational dental hygiene competencies.

Results of the QAP Assessment Tool will be incorporated into the registrant’s Online Learning Plan (detailed below) and will inform their guided learning process. The QAP Assessment Tool is completed by ongoing registrants at the start of the five-year QAP cycle, during January, February or March. Completion of the QAP Assessment Tool is a mandatory requirement and the first attempt must be completed before registration renewal will be permitted; the renewal deadline is the last day of March.

Please view the QAP Information Guide for more information about the current QAP Assessment Tool.

Please click here for further information regarding the QAP Assessment Tool Security.

Please read the new QAP Assessment Tool: Your Questions Answered on this page below for more information.

Applications for QAP Field Testers

The College is currently accepting applications for QAP Field Testers.

Please click here for more information.

The BCCOHP Online Learning Plan (OLP) is a component of the registrant portal that can be accessed by registrants via the “Log in” button at the top of this page.

Once logged in, registrants can click on the Online Learning Plan to connect to their OLP Dashboard, which provides a summary of their current QAP cycle. Registrants can also review their Assessment Tool results, access their learning plans, log learning activities, and access a section on modules and training (such as the Jurisprudence Education Module).

The OLP provides registrants with the ability to create and track two types of learning plans:

  • Required Learning Plans
  • Self-Directed Learning Plans

Required Learning Plans

The QAP Assessment Tool may provide registrants with feedback on their areas of knowledge that were identified as needing improvement. These areas will be grouped into categories and must be addressed through development of “Required” Learning Plans. Registrants will define their own individualized learning goals and action plans that are appropriate to their situation and practice. The College recommends a minimum of two learning activities be completed per Required Learning Plan. Required Learning Plans, if assigned, are mandatory and will be monitored by the College through an audit process.

Self-Directed Learning Plans

Self-Directed Learning Plans are optional and may be used by registrants for planning ongoing professional development and tracking continuing competency learning activities. Registrants are encouraged to develop self-directed learning plans as part of their ongoing commitment to life-long learning and quality assurance.

Help and Resources

The OLP Help and Resources section below contains additional materials for registrants to utilize including the QAP Information Guide, tutorial videos to navigate the OLP, and supporting resources for developing learning goals and action plans.

Learning Activities and Credit Eligibility

In order for learning activities logged in the OLP to be eligible for Continuing Competency (CC) credit, the content of learning activities must be applicable to the individual registrant’s practice of dental hygiene.

Detailed information on the types of activities that may be eligible for credit is found in Part 5 of the QAP Information Guide. Additionally, registrants can access an at-a-glance reference: the QAP Learning Activity & Credit Framework.

Feedback and information has been gathered about the Dental Hygienist Quality Assurance Program (QAP) since the program’s inception in 2012. The information that has been gathered about the QAP has helped identify areas that are working well, as well as areas that can be further enriched. Upon the program’s first five-year milestone a report on the evaluation of the QAP was released. Readers are invited to view the Executive Summary and the full report here.

QAP Assessment Tool: Your Questions Answered

The Quality Assurance Program Assessment Tool serves two purposes. First, the College requires assurance that registrants have remained current in their foundational dental hygiene knowledge to practice safely, so a successful/unsuccessful threshold is a critical aspect of the program. Second, this success threshold identifies a small minority of registrants who require further assessment and support to improve their practice. This is done through the second assessment tier: an on-site Professional Performance Assessment which entails a documentation audit based on the College’s Practice Standards. The registrant works collaboratively with a QAP Assessor and the College to determine a directed learning plan to remediate in the necessary areas.

No. Registrants who have two unsuccessful attempts on the QAP Assessment Tool enter the second tier of the Quality Assurance Program for a Professional Performance Assessment (PPA). The Quality Assurance Committee, which oversees registrants who are involved in the second tier of the QAP, does not have the ability under the Health Professions Act or the College Bylaws to remove a registrant’s licence.

The Proctorio plugin provides security features for the QAP Assessment Tool, including temporarily disabling the ability to copy, paste, or print while taking the tool. These features were built-in to the previous tool, but the platform for the new tool does not have that functionality, which is why Proctorio was used beginning in 2021.

It is in registrants’ best interests to maintain the integrity of the QAP Assessment Tool. Substantial investment was required to create the tool and if it were compromised in any way, registrant funds would be needed to address this.

While Proctorio has the capability to deliver other enhanced security features such as video proctoring, those are not enabled for the College’s tool, nor are they expected to be in future.  Furthermore, the law does not allow the College to engage these features without your explicit consent.

One benefit of Proctorio is that if you have an IT issue while completing the assessment, the College is able to verify that, and allows us to issue a re-take for free.

The new version of the QAP Assessment Tool was developed by BC dental hygienists from a wide range of practice setting, including clinical practice. The proportion of registrants who were not successful after a first attempt in 2021 is nearly identical to that of the previous tool: 4 per cent of the 2021 cohort compared to an average of 3 per cent for the cohorts over the previous eight years. That said, the QAP Assessment Tool would not be an appropriate assessment if the questions were too easy. In addition, feedback from the QAP Assessment Tool is intended to guide professional development which also contributes to enhancing knowledge, currency, and competency.

The Health Professions Act (HPA) requires each BC health regulatory college to develop a quality assurance program that includes an assessment component as a measure of public assurance that health professionals are remaining current and competent in their practice.

The amalgamation will merge four oral health colleges in B.C., but the mandate of the new regulator will be the same, to regulate all the oral health professions in the public interest and ensure that it is fulfilling its obligations under the Health Professions Act.

 The resources required to create and maintain modules like the Jurisprudence Education Module (JEM) can be covered through registrant renewal fees as the content requires minimal updates each year. More resources are needed to maintain the QAP Assessment Tool as the process to develop content for an assessment that is current and defensible is more robust and complex. The $85 fee reflects the resources required for the ongoing development of the tool which is necessary both to maintain its security and to have a current and accurate question item bank. To ensure transparency and fairness, the Board decided to charge a fee at the time a registrant completes the QAP Assessment Tool, rather than increasing registrants’ annual fees to cover the cost.

It is worth noting that the new Assessment Tool is cheaper than the previous assessment tool ($85 instead of $125 plus tax).

 As the new tool has an interactive question format, we recognize that it may take some registrants more time to complete than the previous multiple-choice tool. In recognition of this, we have extended the allotted time to 3 hours from 2.5 hours and the number of questions has been reduced from 75 to 70. Of the 2021 cohort, 69 per cent completed it between 2.5 and 3 hours, 22 per cent between 2 and 2.5 hours, and 7 per cent in less than two hours. While the maximum amount of time has increased, registrants can finish the tool more quickly if they choose.

We’re not looking into developing a mobile friendly version at this time as the platform does not support touchscreen technology for smartphones and tablets, including iPads. A computer in a quiet environment is recommended.

Evaluation of the Tool is one of the guiding principles of the Quality Assurance Program and is done in a number of ways. Data on overall performance is gathered and monitored annually (e.g., the proportion of the annual cohort who are successful/unsuccesful, average time spent taking the Tool, etc.) as is data on performance within content categories. There is also a survey that registrants in the annual cohort are asked to complete after they’ve finished taking the Tool and it is hosted and analyzed by an independent research firm. In addition to these evaluation measures which have been ongoing, evaluation of the questions on the Assessment Tool is undertaken by a psychometrician since the Assessment Tool was brought in-house. The psychometrics review and analysis looks at things like whether the questions perform as expected, the difficulty level for the questions individually and the Tool overall, and whether the different question formats are performing in a fair and defensible manner.

Feedback from registrants who were part of the 2021 cohort has been heard. Responses were received from 49 percent (219) of Dental Hygienists in the 2021 cohort, a notable increase from the response rate in previous years.

A spring 2021 review of the revised Assessment Tool validated that the assessment is valid, reliable and fair. Feedback about the question format has been heard, but also weighed against feedback received on the previous Tool from registrants who did not like the multiple-choice format as it is not reflective of real life. The question format for the revised Tool will not be changing.

A fulsome review of the questions was completed as part of the normal course of reviewing the Assessment Tool. Some questions were identified that were updated to ensure currency, or in a few cases were retired and replaced for the 2022 Assessment Tool.

Through analysis, it appears registrants received an average of 1-2 more sub-categories than in their last QAP cycle. With the revised Tool, there was a slight change to the tool blueprint as well as an increase in the variety of questions in the item bank. This allowed for a better balancing of questions across the subcategories than the previous tool. This is why some registrants may have received a small increase in the number of subcategories assigned in their Online Learning Plan (OLP).

The purpose of the Quality Assurance Program is to ensure knowledge across all areas of foundational dental hygiene practice. The goal is not to create a tool that only covers a respective registrant’s main area of practice. As such, there may be some aspects of the assessment that do not relate to a hygienist’s current practice environment. Since the College does not regulate practice environments, all registrants are expected to have some foundational knowledge of all areas of practice. The number of questions about different practice settings is proportionate to the settings that registrants practice in. For example, there were only 2 or 3 questions about practicing in a community public health setting out of 70 questions.

The benefit of the Tool is not the regurgitation of knowledge but the application of knowledge in scenarios that are similar to what you see when treating clients in real life. As registrants often need to make multiple decisions or assessments for a single situation in their practice, the Tool does not offer partial marks to reflect actual practice.

As local anesthesia is considered part of the blueprint for the QAP Assessment Tool, there are also questions about the administration of local anesthesia in the Tool. All registrants need to have foundational knowledge of pain management, regardless of if, or how often, they administer LA. This won’t change with the launch of the LA Module.

Unfortunately, the incorrect answers in the revised Tool cannot be shown as the new platform lacks the functionality to only show questions answered incorrectly. Dental Hygienists are encouraged to reflect on how their assigned sub-categories apply to their area of practice. The goal is not to “correct” the question that was answered incorrectly. The goal is for the assigned sub-category to assist in directing learning in that area as it applies to a registrant’s practice. As such, there is little value in reviewing incorrect answers on the Tool. In addition, by publishing any answers, it puts the security and validity of the tool at risk.

Online Learning Plan FAQs

The QAP Assessment Tool provides feedback on what is measured as the lowest scoring content subcategories; these are automatically identified and included in the required learning plan (RLP) section of the Online Learning Plan (OLP). Registrants are required to consider and use this feedback to create learning plans to improve knowledge in each subcategory identified. Goals and action plans for RLP(s) are mandatory and may be audited by BCCOHP.

Self-directed learning plans (SDLP) are determined and completed by registrants at their discretion. Goals and action plans for SDLP(s) are entirely for the personal and professional benefit of registrants’ ongoing professional development. It should be noted that the College encourages registrants to develop goals and action plans for SDLP(s) as part of their ongoing commitment to life- long learning and quality assurance.

Credits can be claimed for a wide range of learning activities, provided that the learning activity in question applies to the individual hygienist’s practice setting and their professional learning (as opposed to leisure activities such as yoga or meditation, which are not acceptable for credit). Credits may be applied to a required learning plan or a self-directed learning plan, or towards the general minimum requirement of 75 credits per QAP cycle.

An overview of the QAP Learning Activities / Credit Framework can be accessed on the website. It is important to note that some activities have credit limitations and/or additional requirements. For example, reading a journal article or a chapter in a dental hygiene textbook has a maximum allowance of 30 credits per cycle, as well as the additional requirement to complete a reflection. If there are additional requirements for the learning activity a registrant has completed, they will be prompted to fill out the necessary information when entering the activity in their OLP. Comprehensive information on the types of activities that can be claimed for credit can be found in Part 5 of the QAP Information Guide.

Each question on the QAP Assessment Tool corresponds to a dental hygiene content subcategory. Each registrant’s lowest scoring area(s) will be added to the required learning section of their OLP. Registrants who score low in many areas will need to develop more required learning plans.

Required learning plans are auto populated within a registrant’s OLP by content sub-category, and registrants will need to create a goal and action plan, link learning activities and reflect on their overall completion of each required learning plan.

There is no specific requirement placed on the amount of credits that should be applied towards each learning plan. However, the College suggests a default minimum of two learning activities per required learning plan. Each registrant is responsible for determining how many or few activities and credits are appropriate for their learning needs in order to fulfill the goals identified in their learning plan(s).

For example, a registrant may have initially decided to attend a 2.5-hour course as a learning activity within a required learning plan. However, upon reflection, the registrant then determines that the course did not sufficiently address their identified learning plan as expected. As such, they decide to pursue additional learning activities to satisfy the learning plan – specifically, they also attend a 2- hour webinar and read a newly published peer reviewed dental hygiene journal article on the same topic.

The following example demonstrates how the registrant then chose to apply the credits obtained toward the one required learning plan. Please keep in mind that this is only one example of how activity credits may be applied within the OLP:

  • Within the Required Learning Plan:
    • After reading the journal article the registrant applied 1 credit toward this learning
    • Upon completion of the webinar the registrant applied 2 credits toward this learning
      • The registrant determined that these two activities addressed their required learning plan, so they linked them to the plan and marked the plan as
    • The registrant then chose not to link the in-person course to this specific required learning plan and the 2.5 credits were considered self-directed learning.
    • From these three activities, a total of 5 credits were counted towards the minimum of 75 credits for this registrant’s cycle – 3 credits towards the fulfillment of the required learning plan and 2.5 credits as self-directed learning.

It is important to note that several of the QAP Learning Activities have a maximum credit limit and therefore it would not be appropriate to claim for more credits than is permitted per QAP cycle.

A proportion of registrants whose QAP cycles are ending are selected each year for a QAP audit and documentation review. These audits review the goals and action plans that were identified to address the registrant’s Required Learning Plan(s), as well as the credit activities logged in the OLP. Registrants are asked to provide the College with supporting documentation for all learning activities reported in the current cycle. The information submitted may include registration receipts, course materials, and handwritten or typed course notes. Registrants are encouraged to upload supporting documentation to the OLP when adding learning activities to ensure the information does not get misplaced and is easily accessible in the event of an audit. The outcome of the audit is reported back to the registrant and the reported learning activity credits that meet the guidelines are confirmed.