A national evaluation of workplace-based assessment tools (WPBAs) in foundation dental training: a UK study. Effective and useful but do they provide an equitable training experience?

A questionnaire study was undertaken with trainers and trainees from 12 deaneries in England and Northern Ireland in June 2010 to evaluate workplace-based assessments (WPBAs) in foundation training. From the sample consisting of 741 trainers and 643 foundation trainees, experience of WPBAs was positive overall, playing an important role in trainees' learning during foundation training and building confidence. However, there is a need for comprehensive training in the WPBA tools used to ensure their efficacy.

Evaluation of workplace based assessment tools in dental foundation training.

OBJECTIVE: The aims of this survey were to evaluate the effectiveness of workplace based assessments (WPAs) in dental foundation training (formerly vocational training [VT]). METHODS: Two online questionnaire surveys were sent to 53 foundation dental practitioners (FDPs) and their 51 trainers in the Mersey Deanery at month four and month nine of the one year of dental foundation training. The questionnaires investigated the effectiveness of and trainers' and trainees' satisfaction with the WPAs used in foundation training, namely dental evaluation of performance (D-EPs), case-based discussions (DcBD) and patients' assessment questionnaires (PAQs). The questionnaires also investigated the perceived impact of reflection and feedback associated with WPAs on clinical practise and improving patient care. RESULTS: A total of 41 (7.4%) FDPs and 44 (86.3%) trainers responded. Of the 41 FDPs, the majority found that feedback from WPAs had a positive effect on their training, giving them insight into their development needs. Overall 84.1% of the FDPs felt the WPAs helped them improve patient care and 82.5% of trainers agreed with that outcome. CONCLUSIONS: The findings from this study demonstrate the value of WPAs in dental foundation training by the use of feedback and reflection in directing the learning of foundation dental practitioners and that this can lead to improved clinical practise and patient care.

Job satisfaction of dental practitioners before and after a change in incentives and governance: a longitudinal study.

OBJECTIVES: to measure changes in dental practitioners' job satisfaction following a contractual change, and compare differences between those transferring from a fee-per-item system (general dental service, GDS) and those previously working under a block contract with the primary care trust (personal dental service, PDS). DESIGN: Analysis of postal questionnaires conducted in 2006 and 2007. PARTICIPANTS: Four hundred and forty dental practitioners responding to the 2006 baseline questionnaire. RESULTS: Although perceived workload was unchanged, global job satisfaction had decreased for 24.7% (31) of GDS dentists and 49.0% (95) of PDS dentists comparing their scores given before and after the contractual change. PDS dentists showed a significant change in attitudes towards feeling restricted in providing quality care (change in factor mean [SD] = -2.88 [0.82]; p < 0.001). They also showed less positive attitudes towards 'respect' (change in factor mean [SD] = -3.70 [0.48]; p < 0.001). CONCLUSIONS: The 2006 contractual change appears to have had a negative impact on dentists' job satisfaction and has not addressed concerns which have led dentists to move into the private sector. The study indicates that the fall in job satisfaction is more a result of a perceived erosion of professional autonomy than a reaction to the change in the system of remuneration.

An investigation of current endodontic practice and training needs in primary care in the north west of England.

OBJECTIVE: To investigate current endodontic clinical practice in the north west of England and evaluate practitioner's training needs. METHOD: A questionnaire was posted to 702 primary care dentists in the north west of England in January 2006. The questionnaire investigated aspects of dentists' endodontic clinical practice, the provision of endodontics within their practice, their recent postgraduate training in endodontics and their training needs. RESULTS: Responses to the questionnaire were received from 498 (70.9%) primary care dentists, of which 449 questionnaires contained useful information. Only 30% of respondents use rubber dam for isolation in all endodontic cases. The majority used radiographs either as the only method for establishing the working length (57.3%) or in conjunction with an apex locator (34.5%). Most dentists used sodium hypochlorite solution as an irrigant during the root canal treatment. Almost 55% used a combination of conventional hand files and rotary files to prepare root canals. Fifty-eight percent used the crown down technique while 35% used the step back technique for canal preparation. Almost two-thirds routinely used non-setting calcium hydroxide as an intra-canal medicament. Lateral condensation technique was the popular obturation method and the vast majority of respondents routinely took postoperative radiographs. Almost 25% of respondents had not received any teaching or training in endodontics in the past two years. CONCLUSIONS: The results of this study suggest that primary care dentists in the north west of England have embraced modern techniques and follow most aspects of accepted endodontic practice. Despite the majority having postgraduate training in the last two years, only a minority used rubber dam routinely for endodontic treatment.

Measurement of attitudes of U.K. dental practitioners to core job constructs.

OBJECTIVES: To develop a measure to identify dental practitioner attitudes towards core job dimensions relating to job satisfaction and motivation and to test this against practice characteristics and provider attributes of U.K. practitioners. RESEARCH DESIGN: an 83-item questionnaire was developed from open-ended interviews with practitioners and use of items in previously used dentist job satisfaction questionnaires. This was subsequently sent to 684 practitioners. Item analysis reduced the item pool to 40 items and factor analysis (PCA) was undertaken. RESULTS: 440 (64%) dentists responded. Factor analysis resulted in six factors being identified as distinguishable job dimensions, overall Cronbach's alpha = 0.88. The factors were: 'restriction in being able to provide quality care (F1)', 'respect from being a dentist (F2)', 'control of work (F3)', 'running a practice (F4)', 'clinical skills (F5)', and 'caring for patients (F6)'. All six factors were correlated with a global job satisfaction score, although F1 was most strongly related (r = 0.60). Regression model analysis revealed that 'whether the dentist worked within the National Health Service or wholly or partly in the private sector' (p < 0.001), 'time since qualification' (p = 0.009), and the position of the dentist within the practice (whether a practice owner or associate dentist), (p = 0.047) were predictive of this factor. CONCLUSIONS: Six core job constructs of U.K. practitioners have been identified, together with several practice characteristics and practitioner attributes which predict these factors. The study demonstrates the importance of refining measures of dentists' job satisfaction to take account of the culture and the system in which the practitioner works.

Facets of job satisfaction of dental practitioners working in different organisational settings in England.

INTRODUCTION: Before April 2006, English dentists were either working as an NHS general dental service (GDS) practitioner (fee-per-item, no local contractual obligations); an NHS personal dental service (PDS) practitioner (block contract with the primary care trust (PCT)); a private practitioner (either fee-per-item or capitation-based, independent of the PCT); or in a situation where they were mixing their NHS work (either under the GDS or PDS arrangements) with private work. OBJECTIVES: To a) investigate the extent of the mix of NHS and private work in English dentists working in the GDS and PDS, b) to compare global job satisfaction, and c) to compare facets of job satisfaction for practitioners working in the different organisational settings of PDS practices, GDS practices and practices where there is a mix of NHS and private provision. Method A questionnaire was sent to 684 practitioners, containing 83 attitudinal statements relating to job facets, a global job satisfaction score and questions concerning workload. RESULTS: Response rate was 65.2%. More PDS than GDS dentists were found to treat the majority of their patients under the NHS. GDS dentists working fully in the NHS were least likely to be satisfied with their job, followed by PDS practitioners and then GDS dentists working in mixed NHS/private practices. Private practitioners were the most satisfied. CONCLUSION: Differences between GDS, PDS and private practitioners were found in global job satisfaction and in the facets of job satisfaction related to restriction in being able to provide quality care, control of work and developing clinical skills.

Undergraduate training as preparation for vocational training in England: a survey of vocational dental practitioners' and their trainers' views.

AIMS: To compare the views of new vocational dental practitioners (VDPs) and their trainers regarding how undergraduate dental education has prepared them for their vocational training (VT) in England. This study also aims to identify areas of relative weakness in dental undergraduate education that could influence the future training needs of vocational trainees. METHOD: Structured postal questionnaires were completed by VDPs and trainers from five Deaneries in England. The usable response rate was 71% (n = 186 VDPs and 186 trainers). RESULTS: The vast majority of VDPs and trainers perceived the undergraduate training in history taking, diagnosis and treatment planning for general practice to have been covered 'well' or even 'very well'. Undergraduate training in routine restorative dentistry, oral pathology and paediatric dentistry was also perceived to have been covered well. However, a large proportion of VDPs and trainers reported that they felt that undergraduate training in orthodontics, molar endodontics, surgical endodontics and surgical extraction of teeth had not adequately prepared them for VT. CONCLUSIONS: Newly qualified dentists appear to lack certain competencies recommended by the General Dental Council in The First Five Years. This has implications for dental undergraduate education, but also highlights current training needs during VT.

Where do VT trainers go?

Vocational training (VT) has been running since 1985 in the Northern Deanery, first as a voluntary scheme and continuing right through to the present time. In 1985 there were six vocational practices and now there are 48 one-year VT practices and 12 practices dedicated to pilot the two-year general professional training schemes. During that time many practices have been involved, but not all have reapplied in subsequent years. As it is such a large scheme it is necessary for practitioners to apply every year to be vocational trainers, either as new applicants or those who have had vocational trainees before. This paper looks at the reasons why previous trainers have not reapplied, and looks at any outcomes that may be put in place in order to facilitate or improve the quality and number of VT applications each year.

The emergency drugs box--time for action?

Many GDPs are confused about which emergency drugs they should stock. There is a lack of uniform advice on this topic. Most recommended lists of emergency drugs contain superfluous medications which GDPs would never be expected to use. This paper rationalises the content of the emergency drugs box and provides clear, standardised guidance. A list of ten essential emergency drugs is presented, all of which can be administered by simple routes. Every GDP should be trained and competent to use these essential emergency drugs.