New dental graduates transition into UK professional practice; a longitudinal study of changes in perceptions and behaviours through the lens of evidence-based dentistry.

BACKGROUND: This longitudinal study using qualitative methodology aims to investigate the perceptions, and implementation, of evidence-based guidelines into practice among new dental graduates (NDGs) during their transition from university into professional practice, by identifying factors that influence the adoption of evidence-based practice (EBP) in dental practice. METHODS: The study invited NDGs from one UK dental school (N = 66) and employed longitudinal, multiple qualitative methodologies for data collection, throughout the participants' Vocational Dental Training (VDT) year. Initial interviews (Interview 1) conducted upon graduation and follow-up interviews (Interview 2) carried out between six and nine months into professional practice were combined with participants longitudinal audio diaries (LADs) recorded between the interviews. RESULTS: A total of 12 NDGs agreed to participate. For Interview 1, twelve participants were interviewed, seven of whom agreed to participate in Interview 2 and six recorded the LADs. Interview 1 exposed diverse views among NDGs about EBP, acknowledging its significance but facing obstacles in implementation due to time and financial constraints. They intended to use evidence selectively, often aligning with trainers' or NHS treatment options, while hesitating to fully embrace EBP in a busy dental practice. During VDT, LAD entries showed initial enthusiasm for EBP, but integrating evidence-based guidelines within the NHS system led to pragmatic treatment decisions, balancing gold-standard and cost-effective options. Over time, NDGs became more comfortable with alternative treatments, considering patients' financial constraints, yet they expressed frustration with external pressures limiting their clinical decision-making autonomy. In Interview 2, after six to nine months in practice, NDGs exhibited mixed attitudes towards EBP. Some actively used dental guidelines like SDCEP, others associated EBP with hi-tech or expensive materials, while others would thought to rely on colleagues' recommendations. None consistently sought direct evidence for treatment decisions. CONCLUSION: NDGs' attitudes towards EBP changed and became more negative over their first year in professional practice, leading to challenges in their applying it. It questions the assumption that teaching EBP during undergraduate education ensures its implementation. Further understanding the influences on the development of attitudinal challenges will help to devise effective strategies for fostering lifelong learning and supporting evidence-based practice in dentistry.

A longitudinal qualitative multi-methods study of new dental graduates' transition journey from undergraduate studies to professional practice.

INTRODUCTION: New dental graduates' (NDGs) transition to professional practice is an important landmark and developmental stage in their career and in the UK it is supported by a formal educational transition process through a one-year salaried practice-based programme. However, little is known about graduates' experiences during this period. As part of a larger mixed-methods project, this study aimed to explore NDGs' experiences during their transition to professional practice, represented by Vocational Dental Practice. MATERIALS AND METHODS: Sixty-six NDGs from one dental school were invited to participate. Two rounds of in-depth interviews were conducted: Interview 1 upon NDGs' graduation and then Interview 2 was a follow-up interview after they had spent six-nine months in vocational dental training (VDT). At Interview 1, a subset of participants agreed to record longitudinal audio-diaries (LADs) and continued these for 6-9 months into VDT. Data from the interviews and LADs were analysed together using a thematic analysis approach. RESULTS: Eleven of the 66 invited NDGs agreed to be interviewed at Interview 1 (16.6%), seven at Interview2 (10.6%), and six (9.2%) recorded LADs. Four topic summaries were developed around NDGs transition experiences: (1) conceptualisation of the process; (2) responses to the transition, (3) challenges and support and (4) relationships with stakeholders. CONCLUSION: NDGs' transition to professional practice was perceived as exciting and rewarding on personal and professional levels but carried challenges. VDT and related stakeholders play a vital role of supporting NDGs into their new professional life.

A longitudinal study of changes in new dental graduates' engagement with evidence-based practice during their transition to professional practice.

Introduction Clinicians' use, interpretation and application of evidence in everyday practice is fundamental to their delivery of appropriate, contemporary, high-quality dentistry. Little is known about whether new dental graduates' (NDGs') perspectives and use of evidence-based practice (EBP) change when they enter professional practice.Aim To explore changes in NDGs' perception of EBP for: self-efficacy; knowledge of EBP principles; attitudes; confidence in appraisal skills; and frequency of accessing evidence.Methods Two pre-validated instruments: knowledge, attitude, confidence and accessing EBP resources, EBP confidence scale, and clinical scenarios. NDGs from one dental school completed the questionnaire upon graduation (R1) and six to nine months into vocational dental training (R2).Results Response rates of R1 were 34 (52%) and R2, 21 (62% of R1, 32% overall). Between R1 and R2, knowledge (median [25th-75th percentiles]: R1 = 4 [2.5-4]; R2 = 3 [2.8-3], p = 0.07), self-efficacy (R1 = 645 [587-782]; R2 = 630 [550-690], p = 0.8) and scores related to knowledge of gold standards were comparable. However, attitude (R1 = 38 [34-39], R2 = 27 [25-30]), confidence in appraisal skills (R1 = 16 [14-20], R2 = 11[8-16]) and frequency of accessing evidence (R1 = 26 [22-28]; R2 = 18 [16-19]) all showed statistically significant reductions.Conclusion After six months in professional practice, NDGs showed statistically significant reductions in the value they place on EBP, their EBP-related skills and their use of reliable evidence sources. There were no differences in their 'self-efficacy' knowledge of EBP principles.

Dental students' perceptions of learning communication skills in a forum theatre-style teaching session on breaking bad news.

INTRODUCTION: Communication skills are an integral component of dental undergraduate education. Due to the complex nature of these skills, didactic teaching methods used in other educational contexts can be limited. Interactive and participative methods rooted in modern adult learning theories, such as Forum Theatre, may be more effective in the teaching of communication skills. AIM: To explore the usefulness of Forum Theatre in teaching clinical undergraduate dental students how to break bad news to their patients. METHODS: A purposive sample of 4th-year undergraduate dental students was invited to participate. An evaluation questionnaire was given to the students and collected after the Forum Theatre interactive session. Participants were asked to provide self-reported accounts on the most and least useful parts of the session, as well as the most important learning outcome. Usefulness of the session in clinical work, increasing confidence and ability in breaking bad news, were evaluated via a 5-point Likert-scale type question. Qualitative data were analysed using Framework Analysis to explore the themes found in the open-text component. Descriptive statistics were used to analyse the Likert-scale items. RESULTS: One hundred and fifteen completed questionnaires were collected from the 2015 and 2016 classes. Most students gave the Forum Theatre session a rating of 3 or above on a 5-point Likert scale; indicating that they found it useful. Qualitative results also showed that most participants liked the teaching session thanks to its interactive nature, the use of actors and the input of the facilitators. The majority of students showed preference towards smaller groups which give everyone equal opportunity to participate without unnecessary repetition. CONCLUSION: The results seem to confirm previous findings. Students rated their learning experience involving Forum Theatre favourably. Smaller groups and trained facilitators are required for the success of this teaching method. Further research is needed to assess the long-term educational benefits of Forum Theatre.

Mother's Perception of General Family Functioning and Sugar Consumption of 3- and 4-Year-Old Children: The East London Family Study.

Frequent consumption of sugary foods is a common risk factor for chronic diseases such as dental caries and obesity. Dietary patterns are acquired at home during early life and form a blueprint for dietary behaviours in later life. A favourable family environment can provide a supportive context that enhances the adoption of healthy dietary habits. The aim of this study was to identify the contribution of general family functioning towards the frequent consumption of sugary foods by 3- and 4-year-old children in Outer North East London. The research question was explored with data from the East London Family study, which collected data through home visits from a representative sample of adults and children living in Outer North East London in 2008-2010. This study analysed data from 3- and 4-year-old children (n = 698) and their mothers and included logistic regression, conceptual hierarchical modelling and mediation analysis. The results showed that 17% of the sample consumed sugary foods more than 4 times per day, and that effective general family functioning may help reducing frequent consumption of sugary foods. There was a 67% reduction in children's frequent consumption of sugary foods with every unit increase in the general family functioning score. Mother's higher education may also help reduce the frequent consumption of sugary foods by children. The negative impact of mother's lower education was buffered by the effect of effective general family functioning. The study findings underscore the prospect of identifying factors that contribute to the acquisition of good dietary behaviours.