Role models and professional development in dentistry: an important resource: The views of early career stage dentists at one academic health science centre in England

Diversifying the dental curriculum: A review of the Bachelor of Dental Surgery degree reading lists in a UK dental school

INTRODUCTION

Analysis of the diversity of reading lists on courses offered by universities is one way to assess what is being taught and how it shapes our understanding of the world. Very little work has been carried out so far within dentistry on decolonising the curriculum. Existing work looks at the representation of women or ethnic minorities but not at the dental curriculum per se. This article starts to address this.

METHODS

The reading lists within the 5 year Bachelor of Dental Surgery curriculum in a large UK dental school were collected and assessed. A data extraction spreadsheet was developed and journal articles on every course reading list across the 5 year curriculum were read in detail. Information on authorship and author affiliations, alongside patient and population representation within the article itself, were collected and collated.

RESULTS

We found that there are 2.5 times more male authors than female authors, and almost three times more male lead authors in the articles evaluated. The majority of journal articles included in the reading lists are written by academics and/or clinicians affiliated with institutions in the United Kingdom and most articles are from the global north. In addition, 65% of articles do not specify the focus patient or population group studied.

DISCUSSION

It is unlikely that current reading lists within dentistry fully reflect the composition of the profession itself, the variety of knowledge needed to provide evidence-based practice in a globalised oral health arena or the heterogeneous nature of the patient population.

Switching off automatic pilot to promote wellbeing and performance in the workplace: the role of mindfulness and basic psychological needs satisfaction

Introduction and method

Building on self-determination theory, this study aims to advance the happy-productive worker thesis by examining a sequential mediation linking trait mindfulness to task performance through basic psychological need satisfaction and psychological wellbeing at work. Whereas most of the papers published on the topic stem from USA and Europe, we tested our model in a Canadian sample of 283 French-speaking workers.

Results

Based on structural equation modeling, results show that the three need satisfactions at work mediate the relationship between trait mindfulness and psychological wellbeing at work. Rather than observing a sequential mediation, we find an indirect effect of trait mindfulness on task performance through the satisfaction for one of the basic psychological need (i.e., competence).

Discussion

The present research goes beyond previous studies by exploring a new pair of happy construct-productive criteria alongside an emergent intrapersonal factor contributing to this relationship.

Widening Access: what do dental school websites signal to prospective students?

Introduction Widening Access (WA) policies aim to ensure that a professional workforce reflects the community that it serves by facilitating the admission of applicants from under-represented demographics. WA has not been extensively studied in UK dental education. Website discourses are an important element in students' higher education choices and have the potential to engage those who might be under-represented.Methods Critical discourse analysis was used to investigate contents of the 16 UK dental school webpages in relation to WA, based on a previous study within medical education. Data were contextualised through identification of drivers and levers, as well as warrants of WA.Results Discourses emphasising social mobility, and the resultant advancement within social hierarchy of an individual, dominated the narrative rationalising WA as an initiative. WA was depicted as a mechanism to support applicants of high academic ability and exhibiting commitment to studying dentistry but who were unable to show their true potential due to their underprivileged backgrounds. This presentation portrayed dental schools as generous establishments, selectively granting career-advancement opportunities to disadvantaged students. Discourses on the benefits of WA for patient care and workforce diversification were largely absent.Conclusions Discourses representing WA on websites of UK dental schools are limited and do not portray applicants from deprived backgrounds or under-represented groups as individuals bringing unique positive benefits to dentistry and patient care. We encourage dental schools to consider alternate messages for attracting applicants from under-represented demographics.

Stress/Resource Complex, Sense of Coherence and Professional Identity Among Nursing Students: A Latent Profile and Mediation Analysis

Purpose

Sense of coherence is significant to mental health and professional development in nursing students. However, the association among stress/resource complex, sense of coherence, and professional identity is less explored in nursing students. This study was designed to identify latent subtypes of stress/resource complex and to evaluate the mediating role of sense of coherence between stress/resource complex types and professional identity in nursing students.

Participants and Methods

A total of 595 nursing students were recruited from Be Resilient to Nursing Career (BRNC) between October and December 2021 and administered with 10-item Connor-Davidson Resilience Scale, General Self-efficacy Scale, 10-item Chinese Perceived Stress Scale, 13-item Sense of Coherence Scale, and Professional Identity Questionnaire for Undergraduate Students. Latent profile analysis and mediation analysis were performed.

Results

Three latent subtypes of stress/resource complex were identified: Flexibility (14.8%), Ordinary (44.2%), and Maladjustment (41.0%). Nursing students with role model were prone to Ordinary (OR = 1.48, 95% CI 1.03–2.13, p = 0.035) and Flexibility (OR = 1.92, 95% CI 1.17–3.16, p = 0.011). The association between stress/resource complex types and professional identity was mediated by sense of coherence (P < 0.05).

Conclusion

There exists heterogeneity in nursing students’ stress/resource complex. The association between stress/resource complex subtypes and professional identity was mediated by sense of coherence.

Self-Efficacy and Professional Identity Among Freshmen Nursing Students: A Latent Profile and Moderated Mediation Analysis

This study was designed to estimate the associations between self-efficacy and professional identity. A total of 1,051 freshmen nursing students (FNSs) from the Be Resilient to Nursing Career (BRNC) program were recruited from four universities between September and November 2020. A latent profile and moderated meditation analysis were performed. Four profiles of self-efficacy were identified and named as Lowest (15.6%), Med-low (45.0%), Med-high (32.7%), and Highest (6.7%). The mediating role of resilience and the moderating effect of role models were also identified. Therefore, self-efficacy, resilience, and role models may be three important factors to professional identity in FNSs and these relationships should be further validated in longitudinal or interventional studies.

Supporting dentists' health and wellbeing - a qualitative study of coping strategies in 'normal times'

Background Research has highlighted multiple determinants of dentists' health and wellbeing, and has raised concerns over workforce morale and retention. Limited research has been undertaken on possible solutions. Thus, the aim was to explore the coping strategies used or advocated by dentists to protect and support their health and wellbeing.Methods This qualitative study involved a purposive sample of dentists working in England taking account of age, gender, career stage, work sector, geographical area, position and route of entry to registration. Dentists were approached via gatekeepers across England to participate in semi-structured interviews. A topic guide, informed by past research, was used to guide the discourse. Informants' views were audio-recorded and field notes were made. Data were transcribed and analysed using an interpretative phenomenological approach to generate theory with the support of the framework methodology.Results Twenty dentists were interviewed from a range of backgrounds. Self-reported coping strategies included a range of strategies for 'taking control', including 'embracing self-care' and 'seeking professional support', while drawing on 'supportive personal and social networks'. Managing professional careers included diversifying through greater 'mixing' of NHS with private work, privatising, specialising, or combining dentistry with another role. Strengthening job security and facilitating diversity of experience remain important for supporting the health and wellbeing of dentists. Selling practices or, in the extreme, completely leaving the profession were considered practical options. At organisational level, building sustainable teams and transforming culture were advocated as important; while at systems level, reforming the NHS and bridging the gap between the profession and regulatory body were considered vital. Additionally, the need for strong professional leadership and wider societal debate was advocated as part of a whole systems approach to enable job satisfaction in delivering high-quality, patient-centred, evidence-based care in future.Conclusion While dentists demonstrated a range of coping mechanisms, multi-level action was advocated to enhance the health, wellbeing and retention of dentists. Systems reform at macro- and meso-levels is urgently advocated to enable fulfilling careers within dentistry, particularly for those at the front line of primary dental care in the public sector. Personal resilience alone will not suffice and recommendations for action are explored to avert a public health catastrophe. This is a time for reflection, debate and action.

The dental core training experience: the views of trainees and their postgraduate training leads

Introduction Dental core training (DCT) is an optional, postgraduate programme with a duration of one to three years that dentists in the UK can pursue to further strengthen their skillset.Aims To understand career motivations and preferences of trainees pursuing DCT, and their perceptions and experiences of the programme.Methods Data were gathered from 176 DCT trainees across England through focus groups or individual paper-based responses to questions, as well as telephone interviews with ten associate postgraduate dental deans/training programme directors.Results Trainees were generally positive about their overall DCT experience. They developed confidence, self-reliance and skills in teamwork and clinical aspects, gaining from exposure to conditions uncommon in general practice. Limitations and challenges varied by post and unit. The importance of broad, cross-specialty experience was recognised. Although run-through training would eliminate unwelcome annual relocation, it was deemed unsuitable for all trainees, particularly those intending a career in general practice.Conclusion DCT appears to be advantageous for those intending careers in general dental practice, those aiming for specialist practice and those uncertain of their future career trajectory. Although trainees reported positive training experiences and significant gains, future considerations are suggested, including maintaining flexibility to accommodate different motives for DCT and limiting across-unit variation.

Black Lives Matter: the impact and lessons for the UK dental profession

Black Lives Matter represents positive action towards equality and inclusivity. The Black Lives Matter protests remind us that, as a society, prejudices and unconscious bias still exist throughout the world. So, how does this inequality impact UK dentistry and what lessons can we learn?Black British dentists and dental care professionals (DCPs) are greatly under-represented in the UK workforce. The cause is multifactorial, but clearly measures need to be made from an early age, as Black prospective students have a 19% acceptance rate into dentistry, compared with 54% white and 41% Asian.As a Black British dental student working with my White British dental tutor, we address barriers that affect Black students and offer recommendations. These struggles are not exclusively related to skin colour, but evidence shows that Black British individuals are more likely to experience detrimental factors.We recognise that it is not the majority that suffer from under-representation, but the minorities; it filters into all aspects of dentistry, including treatment planning and disease diagnosis. Black DCPs and dentists have a contextual understanding of the barriers their communities face and will prove pivotal in workforce diversification. However, we all have a part to play in improving healthcare quality. Together, we can do more.

Assessment of dental residents' professionalism through Professionalism Mini-Evaluation Exercise (P-MEX)

PURPOSE/OBJECTIVES

The aim of the study was to assess the professional behavior of dental residents through Professionalism Mini-Evaluation Exercise (P-MEX).

METHODS

This was a descriptive-analytical study. Content validity of P-MEX form was investigated for use in the context of dentistry. A total of 24-item version of P-MEX consisted of doctor-patient relationship skills (n = 7), reflective skills (n = 5), time management (n = 3), and interprofessional relationship skills (n = 9) was used in the present study. Residents in different dental specialties (n = 56) were evaluated by trained raters (448 times). Data were analyzed by descriptive (mean, SD) and analytical tests (Pearson, ANOVA, and post hoc test (Bonferroni)).

RESULTS

Validity of P-MEX was approved in the field of dentistry. The mean score of professional behavior in residents were reported 2.79 ± 0.24, with minimum and maximum scores of 2.17 and 3.62, respectively. The residents' professional behavior in the domain of reflective skills and doctor-patient relationship skills were lower than the other domains.

CONCLUSION(S)

The results showed that the scores of professional behavior among dental residents were classified in the below expectation level and their scores have followed a downward trend from the second year. Therefore, planning for training and continuous assessment of professional behavior among residents in the faculty of dentistry should be considered.

Clinical and academic recommendations for primary dental care prosthodontics

Prosthodontic practice includes a large proportion of dental care provision, mostly undertaken in primary dental care (PDC) in the UK. However, there is limited research evidence in prosthodontic practice, necessary to tackle key questions to improve oral and dental health. In addition, many overarching challenges exist within the NHS system relevant to prosthodontics. For example, demands on healthcare services from increasing patient expectations, the ever-ageing and growing population, risks of litigation, availability of appropriate care, difficulties with access to care, rapidly emerging treatments and technologies, and ongoing needs for education. This article develops clinical and academic recommendations to improve oral health improvements in PDC prosthodontics, further to recommendations determined by the James Lind Alliance, a non-profit making initiative to tackle treatment 'uncertainties' (http://www.jla.nihr.ac.uk/), and the overarching challenges, which are mentioned above. Considerable clinical and academic author experiences from primary, secondary and tertiary care as well as education and research in prosthodontics are employed. We consider management of networks involving patients, carers, healthcare professionals, industry and academics, in order to increase access to improve oral and general health and help drive dental research, education and communication. We investigate how to manage dental disease and intervene to improve the longevity of restorations and the dentition. Finally, we review how rapidly developing digital technologies can best be utilised, in conjunction with industry, in order to improve oral health.

Academic dishonesty among academics in Malaysia: a comparison between healthcare and non-healthcare academics

BACKGROUND

This study was carried out to gauge the prevalence of academic dishonesty among academics in Malaysian universities. A direct comparison was made between academics of healthcare and non-healthcare courses to note the difference in the level of academic integrity between the two groups. In addition, the predisposing factors and implications of academic dishonesty, as well as the different measures perceived to be effective at curbing this problem were also investigated.

METHODS

A cross-sectional study design with mixed qualitative and quantitative approaches was employed and data collection was carried out primarily using self-administered questionnaire.

RESULTS

Approximately half (52.5%, n = 74) of all respondents (n = 141) reported having personally encountered at least one case of academic dishonesty involving their peers. The results also revealed the significantly higher prevalence of various forms of academic misconduct among healthcare academics compared to their non-healthcare counterparts. Although respondents were generally conscious of the negative implications associated with academic dishonesty, more than half of all cases of misconduct were not reported due to the indifferent attitude among academics. Low levels of self-discipline and integrity were found to be the major factors leading to academic misdeeds and respondents opined that university managements should be more proactive in addressing this issue.

CONCLUSIONS

The outcome of this study should serve as a clarion call for all relevant stakeholders to start making immediate amends in order to improve the current state of affairs in academia.

Work shadowing in dental teaching practices: evaluation results of a collaborative study between university and general dental practices

BACKGROUND

The aim of this study was to investigate the acceptance and assessment of work shadowing carried out by students and dentists in dental practices. Furthermore, the extent to which students perceive an improvement in their specialised, communication and social competencies, was to be examined.

METHODS

61 dental students in their clinical semesters at a German university participated in work shadowing placements at 27 different general dental practices. Before beginning, they received checklists of various competencies that they self-assessed using school grades (from 1 = 'very good', to 6 = 'failed'), which they also repeated after completion. The dentists supplemented this with their external assessments. In addition, the students were requested to fill out a 54-item questionnaire and compose a freely-structured report after the work shadowing; the dentists filled out a questionnaire containing 16 items. The statistical analysis was carried out by means of the Friedman Test, including a post-hoc test (Bonferroni-Holm correction).

RESULTS

The analysis showed a significant overall improvement in the students' self-assessed competencies by 0.71* ± 0.43 grades. With an average of 0.33* ± 0.36, the dentists' external assessment proved significantly higher than the self-assessment. The greatest improvements were perceived by the students in the areas of accounting (1.17* ± 0.77), practice organisation (1.05* ± 0.61) and dentist's discussions (0.94* ±0.80) [*p < 0.05]. The students confirmed experiencing an expansion of knowledge, an improvement in their communication skills and indicated a high degree of satisfaction in regard to the dentists (school grade 1.58 ± 0.93). A maximum amount of satisfaction towards the work shadow students was demonstrated by the dentists, and this form of teaching was assessed with a school grade of 1.69 ± 0.89.

CONCLUSION

Both students and dental practitioners demonstrated a high level of satisfaction in regard to the work shadowing. The students felt their knowledge had increased, viewed the dentists as motivating role models and acknowledged a significant improvement in their specialised, communication and social competencies. Work shadowing in dental teaching practices presents a sensible addition to academic teaching at a university.