A novel approach to promoting change in SHO training in a dental teaching hospital

Contemporary views of dental practitioners' on patient safety

BACKGROUND

There is little known about general dental practitioners' (GDPs) views on patient safety in dentistry; we believe this to be the first paper describing their opinions and ideas for maintaining or improving safe practices.

METHODS

Focus groups were used to gather the views of 12 GDPs (who also hold university teaching contracts) on the following topics: Defining patient safety, the important issues in patient safety, safeguards and tools for maintaining safe care, never events and research priorities. Thematic analysis was performed on the verbatim transcripts.

RESULTS

Key themes from the practitioners included: Medical history (polypharmacy and co-morbidities), competence and skill level, the use of safeguards and tools to ensure safety, the importance of effective communication (including working with a chaperone) and the role of reflective practice. Suggestions for improvement included: effective sharing of information with other healthcare professionals, easy access to guidelines and educational tools, adoption of practice protocols, team working and the use of universal charting systems to limit ambiguity.

CONCLUSIONS

GDPs are well versed in the concept of patient safety and are keen to implement evidence based tools and/or interventions designed to improve safety for their patients.

What is the role of senior house officer or dental foundation year two posts in professional careers? Exploring the motivations for, and perceived benefits of, undertaking SHO posts in two London hospitals

AIMS

To investigate the motivations for, and perceived benefits of, undertaking senior house officer (SHO) posts, and to explore the career pathways of those who do, examining trends in successive cohorts.

METHOD

Postal cross-sectional questionnaire survey of all dental and maxillofacial SHOs (DF2s) who had worked for two South London hospitals within the previous nine years (n=137). Respondents were grouped into three cohorts to enable responses to be examined in relation to respondents' entry to their first SHO post.

RESULTS

There were responses from 83 (61%) potential participants. The most frequent motivation for carrying out SHO posts from 79 (95%) of the respondents was the desire to 'learn from experienced clinicians'. The most common perceived benefit reported by those who had completed posts at the time of the survey was 'an improved understanding of the role of the hospital dental service' from 68 (97%) of those who answered this question. Difficulty in securing a job in general dental practice was not reported as a notable motivating factor, either before or after the implementation of the new dental contract. 'Fulfil approved training post requirements for postgraduate examinations' reduced as a motivator from 28 (88%) for the earlier cohort of SHOs to nine (36%) for the more recent cohort. Fifty-four of 78 (69%) respondents declared a definite plan to seek admission to the General Dental Council Specialist Lists in future, 24 (83%) in the first cohort, compared with 11 (46%) in the last (P=0.05). Of the males, 13 (52%) were significantly more likely to report that they were currently working in general practice compared with 15 (27%) females (P=0.028).

CONCLUSION

The findings suggest that multiple benefits are identified from undertaking SHO posts. However, some of the motivations for undertaking SHO posts may have changed over the nine-year period investigated. Possible influences are discussed. This paper highlights the perceived benefits of junior training posts at a time of significant transition within the profession.

An investigation of the acceptability of undergraduate supervision by Senior House Officers and General Professional Trainees

AIM

This study assessed whether Senior House Officers (SHO)/General Professional Trainees (GPT) are, or would be, comfortable supervising clinical undergraduates, whether they find this to be a valuable experience within their training programme, and whether undergraduates are or would be comfortable with SHO/GPTs supervising them.

METHOD

Questionnaires were distributed to fourth and final year students at Glasgow and Dundee Dental Schools and fourth year students at Newcastle Dental School. Questionnaires were also distributed to SHO/GPTs at Glasgow Dental Hospital and School and Edinburgh Dental Institute.

RESULTS

Seventy-nine per cent of respondent SHO/GPTs were currently not involved in the supervision of undergraduates within their present rotation, 65% of whom stated that they would value the experience of this within their training. Of those involved in supervision, 83% found the experience valuable. Forty-four per cent of students were unsure or not comfortable with SHO/GPTs supervising within an oral surgery department and approximately the same in other departments. Twenty-eight per cent of respondents felt that university lecturers should be the main trainer.

CONCLUSION

SHO/GPTs value supervising undergraduates as part of their training experience. More than half of students are comfortable with SHO/GPTs supervising them. Both groups suggest that SHO/GPTs should receive some form of training in teaching prior to supervising undergraduates.

'On Track' – an educational resource to support dental SHO training

This paper describes the development, implementation and evaluation of an educational resource, "On Track", designed to support dental SHOs throughout their time in post, thereby helping them gain optimum benefit from this important stage in their early postgraduate training. The need for such a resource was highlighted by a previous study undertaken by the paper's key authors with SHOs and their trainers in a UK dental school. Among several areas of change identified by both trainers and trainees were the needs to develop the SHO experience into more than an apprenticeship by improving the trainer/trainee relationship, and to encourage trainee-centred learning and self-appraisal. The key aims of "On Track" were therefore to define the outcomes of SHO training, to facilitate the relationship between SHO and educational supervisor (trainer), and to encourage the SHO in reflective learning and self-appraisal."On Track" was subject to developmental testing with both trainers and trainees to ensure that it could achieve these aims and the resultant resource is described, along with its implementation and evaluation. "On Track" met with mixed success and the reasons behind this and conclusions drawn for the introduction of any future similar resources are outlined.

Senior house officer training in oral and maxillofacial surgery: a national survey

Service commitments have often taken priority over training for many senior house officers. There have been changes, with more planned to make this truly a training grade. We conducted a national postal survey of senior house officers (SHO) in oral and maxillofacial surgery (OMFS) in 2001/2002. A total of 229 replies were received with an estimated response rate around 70%. Almost 60% of these respondents (57.2%) had been a SHO in OMFS for over 3 years. Only 39% had a weekly bleep-free teaching session. Forty-eight per cent did not think undergraduate BDS training was adequate for their job. This 48% of SHOs were significantly less likely to have out patient clinic sessions with a designated trainer undertaking teaching (chi 2 = 6.127, P = 0.013) or have a bleep-free teaching session (chi 2 = 6.896, P = 0.009). Sixty-four per cent had received formal training in medical examination of patients. Twenty-nine per cent had not been appraised during their present post. Forty-two per cent of SHOs in OMFS are in band 3 posts. Improvements have been made, but there is a case for further change.

Learning throughout life: can a progress file help?

Modern dentistry demands continuous professional development. This paper reports part of a project to develop a lifelong learning tool known as a progress file for members of the dental team.

AIM

To elucidate the views of dentists (as employers/managers) and dental therapists (as employees) on the potential use at work of a progress file. To obtain feedback from these groups on a prototype progress file for dental therapists.

METHOD

Consultations were conducted with an opportunistic sample of 15 dentists and 32 dental therapists. Twenty eight dental therapists trialled the prototype for 6 months and 15 dentists appraised it. Opinion was obtained through interview and questionnaire, yielding largely qualitative data, which was content-analysed.

FINDINGS

Both dentists and therapists were positively disposed towards a progress file at work but considered its success conditional upon factors including input from the team leader and rewarding dentists for time spent on supporting file users. Evaluation of the prototype was mainly positive. Trial data bore out many impressions from the consultations.

CONCLUSION

A progress file that addresses the needs of both employers and employees has potential to help all members of the dental team meet the demands of lifelong learning.