Evaluation of student-perceived competence of interprofessional working in Gerodontology.

OBJECTIVE: To evaluate pharmacy, dental and dental therapy undergraduate students' perceived competence of interprofessional working before and after attending an interprofessional education (IPE) Gerodontology workshop. BACKGROUND: Whilst there is international recognition of the importance of collaboration between the dental profession and systemic healthcare providers to enhance patient care, there remains a paucity of research into IPE in Gerodontology. MATERIALS AND METHODS: Pharmacy, dental and dental therapy undergraduate students attended a 2-hour Gerodontology case-based workshop. Students completed anonymised Interprofessional Collaborative Competencies Attainment Surveys (ICCAS) before and after attendance. RESULTS: 108 questionnaires were received, 7 were withdrawn (1 incomplete with only pre-workshop side completed, 6 did not identify degree programme). From 101 included questionnaires, 37 were from pharmacy, 56 dental and 8 dental therapy students resulting in response rates of 84%, 82% and 67%, respectively. Each student group recorded an increase in positive reflective competence median (IQR) after taking part in the workshop. Overall median (IQR) reflective competence before the workshop was 6 (1), 5 (2) and 6 (2) for pharmacy, dental and dental therapy students, respectively, which increased to 7 (1) for all groups. There was variability in reflective competence before attending the workshop between dental and pharmacy students for two questions, and dental and dental therapy students for two different questions. CONCLUSION: All students reported increased reflective competence of interprofessional working following the workshop. These findings suggest that introduction of IPE events into Gerodontology curricula may improve student understanding and appreciation of interprofessional working when providing care for older people.

Representation: raising awareness of opportunities and skill development with undergraduate dental students.

Representatives for dentists are required for many governing committees, local and national, that contribute to many aspects of the profession related to politics, the workplace, education, or community-building. Developing skills as a representative can begin as an undergraduate in student representation systems as part of UK university governance structures. At one UK dental institution, there was a plan to explore the learning and skill development of current student representatives, review the training, identify any areas where there were gaps or where they should be strengthened, and consider whether a new training programme could be developed. Training gaps in the representation process and preference for peer mentoring in training were identified as students acknowledged learning 'on the job' through observation of experienced peers. Current representation training also fell short of highlighting the relevance to their future dental profession. Staff and students co-designed a bespoke programme of training to help students develop their representation skills, as well as align them to the development of professional skills which were determined to be relevant for their future dental career.

Professionalism and dental education: in search of a shared understanding.

Professionalism has profound historical origins; however, the current health care environment in the UK dental sphere is changing, which presents new professional dilemmas that require continued learning and debate. Professionalism is a key aspect of the education of dental students and the lifelong learning and development of dental practitioners. However, 'being' professional can be challenging because while it is recognised as a social good, there is much debate on what professionalism means and how best it can be learned and assessed. Since 2017, the UK Council for the Dental Teachers of Professionalism, consisting of educators from UK dental schools and dental therapy hygiene institutions, has been exploring and debating the role and place of professionalism, as well as sharing challenges and good practice within UK dental education. This paper includes a narrative overview of current thinking in the academic literature on professionalism to consider the use of a shared understanding of professionalism to facilitate conversations between various stakeholders.

From inputs to outputs: an analysis of the changes to learning outcomes for dental undergraduate education in the UK.

Introduction/aims Preparing for practice (PfP) was thought to represent a significant shift in the expectations of dental undergraduates compared to its predecessor, The first five years (TFFY). This project aimed to explore requirement changes by comparing learning outcomes for undergraduate dentists in these two documents. Changes in curriculum requirements defining clinical, professional, or a blend of these skills were also investigated.Methods Curriculum mapping was used to compare learning outcomes in PfP to requirements in TFFY.Results The total number of learning outcomes increased from 101 to 149 in PfP compared to TFFY. There was a proportional reduction in outcomes describing clinical skills and an increase in the proportion of outcomes describing professional and blended skills. Three TFFY requirements did not appear in PfP and a further 23 learning outcomes in PfP were absent in TFFY.Conclusions In the transition from TFFY to PfP, there has been an overall increase in the number of outcomes graduates must attain before they can register with the General Dental Council. There are more outcomes defining professionalism which subsequently has resulted in proportional but not actual decrease in outcomes related to clinical skills. While there is uncertainty over how schools have managed curricula to incorporate these changes and thus whether the perception of graduate preparedness can be directly attributable to these changes, it is timely to consider any changes within dental learning outcomes in the context of preparedness concerns.

Undergraduate dental education: an education or training?

The impact of the COVID-19 pandemic on undergraduate dental education has led to new ways of working, different modes of delivery for elements of programmes and, in some cases, revised timelines for progression. These expedient changes, like the virus, may be with us for some time. However, as we come out of an intense period of critical reflection and change, it may also offer us an opportunity and impetus to revisit unresolved challenges around the focus and role of undergraduate dental education. We reflect upon the necessity for both clinical development and scholarship for our undergraduates, and the subtle differences of purpose between education and training. We consider whether it is time to look afresh at the relationship between the universities and other stakeholders and perhaps also to start with renewed understanding, giving deeper consideration to the value of each. One of the biggest obstacles to resolving these issues is to consider how best we align institutional requirements with the education and training of healthcare practitioners. With the hindsight of the past 12 months, we would argue that such a review is timely and more meaningful as we can reflect on the pandemic-enforced and expedient changes to our programmes and more clearly understand where our future priorities lie.

Professionalism in undergraduate dental education: a pause for thought.

Professionalism in dental education, as well as in the wider dental profession, is a regularly discussed and debated topic. It may seem obvious what is meant by 'professionalism' and in many situations it is clear what constitutes a professional approach or behaviour, but contention exists in how to articulate, measure and consider aspects of this complex and context dependent phenomenon. Getting 'it' right early on, with our students and new graduates, is a strategic priority, contributing to 'upstream' activities which have an intention of preventing future issues or harm. The aim of this article is to summarise the challenges faced by providers of undergraduate education (and the dental regulator) in the UK in defining and determining attainment of 'professionalism' before registration. It is timely to take an opportunity for pause, re-assess frameworks and consider future direction.

Delivering to 'that list': the challenges of working with learning outcomes.

Dental education providers have raised concerns around the challenges experienced when trying to demonstrate student attainment of 'professionalism', as described in the General Dental Council (GDC) document 'Preparing for practice'. This manuscript describes a documentary analysis of each 'outcome' within the dentist professionalism domain section, with an assessment of whether it met the criteria of a functional learning outcome. In addition, outcomes were scrutinised in terms of application within undergraduate degree programmes. Key challenges identified were: the 'outcome list' included standards and objectives as well as outcomes; not all statements were specific and focused, some were broad and multi-faceted; determining attainment where there was no identifiable endpoints; and judging achievability within the supervised and confined environment of undergraduate programmes. We conclude that issues have been created through the way that these learning outcomes have been expressed. Also, it is evident that there are ideological and philosophical issues about accurately articulating the attainment of complex phenomena like professionalism. The findings from this study reflect the challenges associated with using learning outcomes to adequately capture professionalism, the values that underpin it and the behaviours that manifest its existence in clinical practice.

A Pilot Study to Assess Feasibility of Lay Representation in Dental School Admissions Interviews.

Regulatory bodies in the dental profession often include members of the public as a way to ensure that patient interests are represented. With student selection for admission to dental school being a multifaceted, highly competitive process, this study was motivated by curiosity about the value of involving members of the public in the admissions process. At Newcastle University School of Dental Sciences, UK, semi-structured selection interviews conducted by two members of the faculty staff are part of the process. In the 2016-17 and 2017-18 admissions cycles, four lay representatives joined a number of the interview sessions. The aim of this study was to determine the feasibility of having a lay person present during the selection interview and whether this could become an integral part of the admissions process. A secondary purpose was to internally validate the processes in place for the interviews by considering the alignment of judgments of the panel and lay representatives. This study followed a two-stage, mixed-methods design. Quantitative analysis compared numerical interview scores awarded by the panel and lay representative when present. Scores for each question domain and overall interview score were compared. Qualitative analysis was carried out by conducting a focus group with lay representatives to seek insight into their experience and reflections on the interview processes. Thematic analysis was used, and overarching themes identified. The results showed no statistically significant difference between the interview panel and lay persons' scores for each domain or overall score awarded for the interview. The thematic analysis identified three overarching themes: reason for volunteering, process and training, and thoughts on style of interview used. These results suggest that involvement of lay people from the local community was feasible, and there was interest in continuing this involvement from the volunteers themselves.

Patient non-attendance: utilising clinical time.

BACKGROUND: In undergraduate dental or medical programmes clinical time with exposure to patients is limited. A priority for all those involved in the delivery of a clinical programme is to ensure that this time is used effectively and to maximum potential. Patient non-attendance is a reality, and developing organised activities to provide alternative learning opportunities is important. METHODS: We have developed a range of close-contact teaching and learning activities (CCTLs) for dental students to productively use patient non-attendance time. CCTLs are short, skills-based tasks that are directly observed and have structured assessment criteria. Used formatively, they are performed in the clinical environment utilising the materials, equipment and clinical staff usually available during the clinical session. FINDINGS: The CCTLs have proved particularly useful for early-stage clinical students, by developing understanding and skills, reinforcing protocols and promoting the role of the wider dental team in teaching. Students have welcomed these activities and engagement has been high. In addition to improving skills, they have proved helpful in familiarising students with direct observation, and have inspired peer collaboration and feedback. DISCUSSION: The CCTLs have promoted opportunities for students to receive direct feedback, which may be difficult to deliver if a patient were present. Empowering students to lead on their own learning requirements also promotes the ethos of lifelong learning that will be fundamental to future professional development. Investment of resources to develop these activities has proved worthwhile, as we have found that CCTLs can complement and maximise the potential of clinical attachments. Patient non-attendance is a reality, and developing organised activities to provide alternative learning opportunities is important.