In 2014, Lisa Montebello, a Registered Dental Hygienist and Master of Public Health candidate at the Interfaculty program in Public Health, Western University, was working during her practicum with Dr. Mark Gracey, Oral Health Manager of the Middlesex-London Health Unit (MLHU), in London, Ontario, Canada. Her objective was to formulate a clinical calibration assessment and recommendation report. Clinical calibration is a comparison of agreement between clinicians, or against a verified standard, to achieve a clinical gold standard. Dr. Gracey was responsible for following the Ontario Public Health Standards (OPHS) protocols to ensure that all Grade 2 children in the Middlesex-London area were receiving equitable access to oral health care services through oral health screenings. There were over 120 schools with five registered dental hygienists (RDHs), along with five dental assistants (DAs) providing this service through the school screening program. After a calibration review slide session the year before, it was found that the RDHs were rating the oral health care needs of children inconsistently. This posed a dilemma for both Dr. Gracey and Lisa, as vulnerable children with urgent dental care needs may be missed as a result. There was also no standardized recommended statistical analysis in place at MLHU to analyze the data from the calibration sessions. Lisa needed to come up with a best practice guideline for clinical calibration, including statistical analysis recommendations, so that the MLHU could ensure that no child was overlooked due to inconsistent measurement outputs. Lisa had just 8 weeks to observe and assess the entire current calibration system in place, and to formulate a report for the oral health team at the MLHU
