The effect of a training program on the reliability of examiners evaluating amalgam restorations

There have been long-term problems in establishing agreement among clinical and preclinical examiners in dentistry. The purpose of this study was to develop a training program and study its effect on examiner agreement when judging the clinical service ability of amalgam restorations. Ten examiners with varying backgrounds, levels of experience, and no previous training with methods to standardize clinical evaluation evaluated 44 amalgam restorations in 17 patients before and after a brief training session. The restorations were judged as either acceptable (leave alone), or unacceptable (replacement or alteration required). The training program was brief and consisted of the introduction of a rating scale with descriptive criteria, followed by a clinical session where the examiners practiced using the rating scale and criteria to arrive at operational decisions. Intraexaminer and intraexaminer agreement were calculated for both evaluation sessions. The training program improved the reliability of the examiners evaluating the clinical service ability of the amalgam restorations. Although the gain was not to the level commonly accepted in the literature, it clearly demonstrates a step in the right direction.