Students' perspectives of early and gradual transitioning between simulation and clinical training in dentistry and their suggestions for future course improvements.

INTRODUCTION: Students' perspectives on their learning environment are essential for course development and to enhance the educational experience. In dentistry, there is limited understanding of how students perceive their early clinical training. This study presents students' views on their gradual progression from simulation to patient care and describes the approaches they followed to adapt during this transitioning phase. METHODS: A qualitative study design was employed, drawing on focus group discussions conducted with students from the Division of Dentistry at the University of Manchester. The discussions were transcribed verbatim. Data collection and coding process followed the principles of thematic analysis and the inductive approach. FINDINGS: The sample was comprised of 28 undergraduate students, across four focus groups. Thematic analysis generated three key categories: students' immediate perspectives of early clinical training, students' approaches to adapting to the transitioning period and students' suggestions for future improvement. Further, subthemes emerged describing the positive gains which students recognised from their early and gradual clinical involvement and training. Despite experiencing stress and uncertainty, related to insufficient knowledge and immature multitasking skills in the early years of dental training, students were motivated by the clinical environment and identified several ways to adapt to it and enhance their learning. These included additional self-learning resources and simulation opportunities; inter-year group learning activities and further peer support and mentoring. CONCLUSION: The current study provided insights into students' experiences of learning through early clinical involvement and gradual transitioning between simulation and clinical environments in dentistry. The findings revealed that whilst students appreciated being involved in the clinic at an early stage, they had to adopt a variety of approaches to link their knowledge, learning and skills between the simulation and clinical environments. Students' suggested additional activities to link the learning gap between the two environments and to enrich their learning.

The challenge of integrating community pharmacists into the primary health care team: a case study of local pharmaceutical services (LPS) pilots and interprofessional collaboration.

The aim of this paper is to investigate interprofessional collaboration between general practitioners (GPs) and pharmacists involved in the delivery of enhanced pharmacy services under the local pharmaceutical services (LPS) contract in England. Previous research suggests that a number of interprofessional barriers exist between community pharmacists and GPs which hinders the integration of community pharmacists into the primary health care team (PHCT). One of the aims of the LPS contract, introduced in England in 2002 as an alternative to national contractual arrangements, was to enable pharmacists to work more closely with other health care professionals. A two-stage survey was distributed to all pharmacists involved in the first wave of LPS and in-depth interviews undertaken with pharmacists and GPs at six of the LPS sites. Overall the level to which the LPS pharmacists felt integrated into the PHCT did not substantially increase with the introduction of LPS, although co-location was reported to have facilitated integration. New relationships were formed with GPs and existing ones strengthened. A good existing working relationship with GPs was found to be an important factor in the successful operation of the pilots as many were dependent on GPs for patient referrals. The findings suggest that establishing interprofessional collaboration between GPs and pharmacists is a piecemeal process, with a reliance on goodwill and trust-based relationships.