Assessing professionalism within dental education; the need for a definition

Experiences of the use of portfolio in dental education - A qualitative meta-ethnographic literature review

INTRODUCTION

Portfolio with a collection of evidence has become popular in higher education, including dental education. It is valuable to study the experiences of the use and implementation processes. Meta-ethnography can be a suitable method to analyse, synthesize and construct interpretations of qualitative research. Our aim was to explore experiences from the use of a portfolio/e-portfolio in dental education, from the students' and teachers' perspectives.

MATERIALS AND METHODS

A systematic search in the databases PubMed, Scopus and ERC was performed, and the established seven steps of a meta-ethnographic review were used. 278 papers were initially identified, and seven were included in the final analysis.

RESULTS

Two themes (Issues to Address and Consequences) and five subthemes (Purpose, Roles, Support and Structure, Challenges and Enablers, and Gains) were constructed.

DISCUSSION

Our synthesis reflects various challenges, yet the learning gains are recognized and expressed to be important once the students and teachers have overcome early thresholds. Beyond the conclusions drawn in each paper, our synthesis provides new perspectives on the complexity of an implementation process and the balance of not seeing the woods for the trees being overwhelmed by technical and other practical aspects, reducing the opportunity for learning.

CONCLUSION

The portfolio implementation in undergraduate dental education should address clarification to all stakeholders of the purpose and role, presenting a purposeful portfolio structure and timely support.

Contemporary dental student professionalism: moving towards a macro-level perspective

Defining professionalism and developing educational interventions that foster and assess student professionalism are integral to dental education. Nevertheless, conceptual, methodological and pedagogic differences define the academic field, leaving students, educators and the profession itself struggling to make meaningful progress on how best to elicit and monitor dental student professionalism. This article proposes that more progress can be made on this important issue when a contextualised, sociological assessment of dentistry and dental professionalism is undertaken. We contend that identifying some of the socio-cultural demands in UK dental students' lives, and acknowledging how these pressures shape their interactions with the UK dental education system, provides a nuanced and contemporaneous understanding of what it means to be an oral health care professional at a time of social and health care upheaval. Dental educators can use this insight to work towards being more understanding of and responsive to dental student professional development.

Student experiences of professionalism and role models in an oral and maxillofacial surgery internship: A qualitative study

INTRODUCTION

Dental students have a clear concept of professionalism and the importance of role models. Our aim was to determine how dental students experience their first oral and maxillofacial surgery internship in terms of their concept of professionalism and their perception of role models.

METHODS

From June to August 2020, semi-structured telephone interviews were conducted with 22 dental students in their eighth and ninth semesters at the Medical Faculty of the University of Ulm. The interviews were transcribed and evaluated by qualitative content analysis according to Mayring.

RESULTS

The students' concept of dental professionalism was shaped by the elements of a good approach to patients, professional competence, and manual skills. This perception was not changed by the internship. Having a role model was seen as an important learning strategy, and role models were perceived in both positive and negative ways. Role models were perceived as positive if they corresponded to the student's concept of professionalism and as negative if they did not correspond to this concept, especially with regard to social interaction or the approach to patients. Students' reactions to discrepancies between their own moral values and the role models' behaviour were characterised by passivity and withdrawal. With regard to potential future careers, positive internship experiences supported student goals, whereas negative experiences raised doubts about them.

CONCLUSION

Supervising dentists may still underestimate the considerable impact of internships, and their awareness of this impact needs to be increased. Students' reactions to conflicts between reality and their own values do not appear to be constructive. One approach to solving this problem may be to include discussions of professional development in curricula.

Evaluation of Self-Reported professionalism lapses among dental undergraduate students: A cross-sectional study from a Malaysian dental faculty

INTRODUCTION

Professionalism and academic integrity are important components of dental education as they influence not just the present-day learning process, but also the practice of dentistry in future. This study evaluated self-reported professional lapses, academic dishonesty behaviours among peers and recommended sanctions for such lapses.

MATERIALS AND METHODS

Dundee Polyprofessionalism Inventory I: Academic Integrity questionnaire was administered to BDS students of a private dental institution in Malaysia. Differences in the level of recommended sanctions were assessed by Mann-Whitney U and Kruskal-Wallis test.

RESULTS

There was unanimous agreement that all 34 statements of lapses of academic integrity as unacceptable. The highest agreement (95.6%) was related to threatening or abusing university employees or students and involvement in paedophilic activities, whereas the lowest agreement was observed for getting or giving help for coursework against rules (47.3%). The most frequent behaviours observed among peers were lack of class punctuality (55.1%) and providing and receiving proxy attendance services (49.3%). About 36% admitted to not being punctual themselves, 26.8% for accepting or providing help for course work and 22.9% for receiving and providing proxy attendance. Female students displayed stricter recommended sanctions, with the most significant difference relating to joking disrespectfully about body parts (p < .001). More lenient recommended sanctions were observed among Year 1 students compared with other years, with the most significant difference (p < .001) observed for exchanging information about the exam, forging a signature, plagiarising and cut-pasting materials without acknowledgement.

CONCLUSION

The majority of academic lapses were well comprehended. Significant differences were observed in sanctions imposed in terms of gender and year of study.

Are the standards of professionalism expected in dentistry justified? Views of dental professionals and the public

Introduction In the UK, the General Dental Council specifies nine principles of professional standards that dental registrants must follow. There are views that such standards are high, patients' expectations are rising, and the professionalism of dental professionals is increasingly scrutinised. This paper explores whether the high standards expected in dentistry are justified.Methods We applied thematic analysis to 772 free-text responses from dental team members and the public to a modified Delphi survey. Respondents described their views of professional and unprofessional behaviours in dentistry. Data were obtained as part of a larger review of professionalism in dentistry.Results Two lines of argument were identified: professionalism standards are high, but justifiably so; and professionalism standards are too high. Within these, four broad themes emerged: patient trust; comparison with other professions; a culture of fear; and perfection.Conclusion High professionalism standards are justified in a profession where patient trust is paramount. However, a problem lies in the culture that surrounds professionalism in terms of litigation and dental professionals feel pressure to possess an unattainable, infallible nature. These negative impacts need minimising. We suggest that undergraduates and continuing professional development approach professionalism with care, to foster a supportive, positive and reflective culture of professionalism.

Exploring Professionalism among Final Year Dental Students and New Graduates: Translating Knowledge to Practice

OBJECTIVES

 The aim of this study was to evaluate senior students' and dental graduates' perception of professionalism as defined by international regulatory bodies and to assess students' ability to apply such knowledge in clinical-based scenarios.

MATERIALS AND METHODS

 Knowledge of professional competencies was conducted using a survey based on domains of professionalism for a newly qualified general dental practitioner as defined by international regulatory bodies. This survey consists of 32 items addressing participants' perception of three domains of professionalism. Application of the perceived professional competencies was tested by asking participants to answer questions following the observation of a clinical-based scenario video where participants needed to identify issues related to professional, ethical, and communication skills, which were embedded in the scenarios.

STATISTICAL ANALYSIS

 Differences were analyzed using ANOVA and t-tests (p<0.05).

RESULTS

 Data from 146 participants showed no significant differences in the survey scores between the participants' professional levels, place of practice, age groups, and genders. Analyses of correlation between the different domains of professionalism showed significant relationships between pair-wise comparisons of the total domain scores. Paired t-tests revealed that the mean score percentage for each of the three domains of professionalism was significantly higher than the responses reported in the relevant clinical-based scenario questions.

CONCLUSIONS

 This indicates that all domains of professionalism contributed in a similar way to their overall assessment. Furthermore, our findings show that dental practitioners may not be able to apply their knowledge of professionalism in real-life scenarios. This suggests that teaching professionalism at the early stages of the dental curriculum should incorporate innovative approaches to mimic real-life scenarios.

Professionalism and dental education: in search of a shared understanding

Professionalism has profound historical origins; however, the current health care environment in the UK dental sphere is changing, which presents new professional dilemmas that require continued learning and debate. Professionalism is a key aspect of the education of dental students and the lifelong learning and development of dental practitioners. However, 'being' professional can be challenging because while it is recognised as a social good, there is much debate on what professionalism means and how best it can be learned and assessed. Since 2017, the UK Council for the Dental Teachers of Professionalism, consisting of educators from UK dental schools and dental therapy hygiene institutions, has been exploring and debating the role and place of professionalism, as well as sharing challenges and good practice within UK dental education. This paper includes a narrative overview of current thinking in the academic literature on professionalism to consider the use of a shared understanding of professionalism to facilitate conversations between various stakeholders.

An upgrade of the Malmö model by implementing case-based teaching and learning, in an undergraduate dental education

BACKGROUND

At our dental education, the examination failure rate amongst students has increased, resulting in subsequent involuntary dropouts. One of the main problems seems to be that the students struggle with taking the necessary responsibility for their learning, as required by the problem-based learning (PBL) methodology.

AIM

To describe the background to, and the transition process from, pure PBL to case-based teaching and learning (CBT) with flipped classroom seminars at the dental programme at [anonymised for peer review].

METHODS

In this position paper, we describe our observed problems with the PBL methodology, as implemented at this faculty, and the potential benefits of a change towards CBT. The current implementation of CBT is presented, along with educational research supporting the choice of activities.

RESULTS

Tentative findings are that the flipped classroom seminars and the clearer instructions appear to be successful with higher levels of activity, engagement and attendance amongst the students, and the students have evaluated the seminars as very good learning activities.

CONCLUSION

Tentative findings suggest that the current implementation of CBT may be a fruitful way of teaching in dental education today. Most of the teaching staff have been reawakened to teaching, and as a result, the content of the courses are being reviewed and improved. The students appreciate that what is expected of them has been made clearer and that there is a variety of learning activities.

Early Clinical Experience and Mentoring of Young Dental Students-A Qualitative Study

The literature reports that student transition between preclinical and clinical dental education can be traumatic and stressful for many reasons. Early clinical experience has been reported to provide some relief. In this qualitative study, twelve final year dental students were interviewed about their perceptions and experiences with a mentee/mentor (FOAL) program in Aarhus, Denmark, to see if it (1) counteracted stress perceptions from preclinical education to the clinic, (2) inspired professionalism and a sense of study relevance, (3) helped in learning to reflect on competencies and attitudes, (4) helped with clinical social perspectives (communication/contact), (5) helped with motivation to learn and (6) helped to reaffirm one’s professional study choice. Using qualitative description methods with purposeful sampling, data from interviews were collected, transcribed, analyzed and validated with a short questionnaire. The FOAL program, today, has several benefits for mentees, including partially helping in the preclinic to clinic transition and the increased insight into mentors’ clinical tasks and communication with patients. Informants described that FOAL also contributed positively to both mentee and mentor students’ learning motivation, collaborative skills and professional attitudes. Challenges were lack of organization/planning, not enough clinical hours, lack of clinical knowledge and persistent stress levels at the clinical transition. These issues are already being considered in the curriculum reform currently in progress and are also relevant to other dental curricula internationally.

Exploring the impact of digital professionalism awareness training on dental undergraduate students

INTRODUCTION

Since the publication of GDC guidance, there have been small, but rising numbers of Fitness to Practise (FtP) cases made against qualified dentists, relating to the use of social media. Prior to graduation, dental students currently receive training in the appropriate use of social media, but more work is needed to determine the most effective methods do this. The aim of this study is to explore the impact of the digital professionalism awareness training provided at one UK-based institution.

MATERIALS AND METHODS

In year 2, a "brown envelope" is compiled using an online publicly available Facebook profile search for every student. All year 2 to 5 dental undergraduate students at one UK dental school who had completed the "brown envelope" were invited to participate in focus groups to examine its impact on behaviour change. A qualitative framework analysis method was applied to the transcripts.

RESULTS

Eleven dental undergraduate students participated in two focus groups. All students had experienced the "brown envelope" intervention. Four main themes emerged, including: a clear expression of dental student autonomy and rejection of regulation; that online activity in dentistry is different to medicine; that the intervention is useful and changed online behaviour; and constructive suggestions for improving training.

CONCLUSION

The interactive "brown envelope" intervention for digital professionalism awareness training was well received and appeared to result in actionable behavioural change on student profiles (eg alterations in privacy settings or restricting access to their own "friends lists").

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.

A common European Curriculum for Dental Hygiene - Domain I: Professionalism

This position paper outlines the areas of competence and learning outcomes of the Common European Curriculum for Dental Hygiene (CECDH) that specifically relate to Professionalism. Professionalism is a commitment to a set of values, behaviours and relationships, which underpin the trust that the public hold in Dental Care Professionals. Shortcomings within this domain are often responsible for patient dissatisfaction, concern and complaint-and emphasis is placed on the importance of embedding these values from an early stage within the curriculum.

Professionalism in undergraduate dental education: a pause for thought

Professionalism in dental education, as well as in the wider dental profession, is a regularly discussed and debated topic. It may seem obvious what is meant by 'professionalism' and in many situations it is clear what constitutes a professional approach or behaviour, but contention exists in how to articulate, measure and consider aspects of this complex and context dependent phenomenon. Getting 'it' right early on, with our students and new graduates, is a strategic priority, contributing to 'upstream' activities which have an intention of preventing future issues or harm. The aim of this article is to summarise the challenges faced by providers of undergraduate education (and the dental regulator) in the UK in defining and determining attainment of 'professionalism' before registration. It is timely to take an opportunity for pause, re-assess frameworks and consider future direction.

Toward a Global Definition of Professionalism for Nutrition and Dietetics Education: A Systematic Review of the Literature

BACKGROUND

Professionalism of health care practitioners is central to safe and ethical health care, and forms part of the trust that the public places in health care practitioners. Lapses in professionalism in health care present considerable challenges and can have serious consequences and outcomes. Teaching, learning, and assessing professionalism is an important component of nutrition and dietetics education. There is scant peer-reviewed published research related to professionalism in nutrition and dietetics. Providing a definition of professionalism will support progress in curriculum planning and design, teaching, learning and assessment of students, and ongoing professional development of educators and practitioners.

OBJECTIVE

The aim of this study was to conceptualize and define professionalism for the purpose of teaching nutrition and dietetics.

DESIGN

This study included a critical systematic literature review of original research and a targeted and systematic search of national and international dietetics competency standards, exploring the concept and definitions of professionalism in nutrition and dietetics. Competency standards were chosen as an additional focus in the systematic literature search, as they are the key framework documents that guide curriculum development and education standards internationally. Thematic analysis was used to synthesize extracted data and an inductive, interpretivist approach was then applied in conceptualizing a definition of professionalism.

RESULTS

Seven studies and six national and international sets of competency standards were included in the literature review. Four major themes conceptualizing a definition of professionalism for nutrition and dietetics were identified from the integration of the original research and targeted gray literature reviews: 1) personal attributes; 2) interpersonal communication; 3) approach to practice; and 4) commitment to lifelong learning.

CONCLUSIONS

Defining professionalism for nutrition and dietetics supports progress toward shared understandings, building trust, and assisting in dietetics education and practice. It can be used to support and extend teaching, learning, and assessment of professionalism.

Defining professionalism for mental health services: a rapid systematic review

Background: Efforts have been made to define professionalism across the professions, yet little attention has been paid to the concept in mental health services, where patients' needs differ to that in other healthcare specialties. Aims: To derive a definition of professionalism for mental health services using the existing literature. Method: A rapid, systematic review was conducted to identify empirical and non-empirical records that described professionalism in a mental health service context from 2006 to 2017. Studies were synthesised narratively using thematic analysis. Results: Seventy records were included in the review. Professionalism was described on two levels; at a societal level, a dynamic social contract between professions and society, and; at an individual level, having intrapersonal, interpersonal, and working professionalism. Utilising emerging themes, an operationalised definition of professionalism, suitable for a mental health service context was derived. Conclusions: Within mental health services, emphasis is placed on the interpersonal aspects of practice such as communication skills, maintaining boundaries and humanity. Themes relating to the vulnerability of patients and the challenge of supporting autonomy and choice whilst maintaining safety and acting in a client's best interest are also evident. 'Practical wisdom' and a flexible approach to working are needed to manage these challenging situations.

Developing a Dental Scrubs Ceremony to define professional identity and teach professionalism to dental undergraduates; lessons learned

INTRODUCTION

The UK General Dental Council stipulates that professionalism is a key aspect of the teaching and training of dental students. However, dental educators highlight that teaching dental student's professionalism can be challenging and students often rate this teaching activity negatively. This article documents a teaching initiative at one UK Dental School that aimed to strengthen the professionalism curriculum by introducing a Dental Scrubs Ceremony for second-year students.

MATERIALS AND METHOD

The Dental Scrubs Ceremony is inspired by the White Coat Ceremonies that medical students have in universities in North America. It marks the students' first step in their professional and clinical development, with the signing of a pledge of conduct and public presentation of dental scrubs to each student. We report student feedback questionnaire data over a three-year period together with reflections on the merits and limitations of this alternative approach to teaching professionalism.

RESULTS

Student evaluation data show that the perceived usefulness and worthwhileness of a Dental Scrubs Ceremony have grown since its inception in 2015. Most students enjoyed the symbolism of the ceremony, receiving their dental scrubs in a formal event. However, there was mixed evaluation for its effectiveness to teach professionalism.

CONCLUSION

A Dental Scrubs Ceremony is a useful addition to the formal curriculum of professionalism in a dental school. It provides dental students with an opportunity to be inducted into the dental profession as novice dental students starting out on their professional career.

Student perceptions of exodontia competency assessment in a UK dental school

INTRODUCTION

Modern medical and dental training has migrated from assessing only the quantity of procedures performed to a combined assessment of both competency and quantity. This study explores student perceptions of competency assessment in exodontia at a UK dental school.

MATERIALS AND METHODS

Anonymous questionnaires were distributed to dental students in years three, four and five at the School of Dentistry, Cardiff University (n=149). Responses consisted of dichotomous tick boxes and 5-point Likert scales, with thematic analysis of free-text responses. Discrete variables were analysed using simple descriptive statistics. Recurring themes were identified from the responses.

RESULTS

A total of 129 questionnaires were returned (response rate 87%). Feedback from students indicated that they felt well prepared to undertake the competency assessment, agreeing that year three is the most appropriate year to assess competency (69%; n=86). In 50% of cases (n=65), the clinical supervisor was not present for the duration of the assessment. The undergraduate student body would like further teaching in the use of elevators (89%; n=114).

CONCLUSION

The competency assessment was deemed fit for purpose by the undergraduate student body. Further developments in the areas of clinical supervision and teaching on the use of elevators were considered and recommendations made to the School of Dentistry, Cardiff University. The current oral surgery course incorporates some of the recommendations.

The use of virtual patient scenarios as a vehicle for teaching professionalism

OBJECTIVES

This study aimed to measure students' perceptions of virtual patient scenarios (VPs) for developing ethical reasoning skills and to explore features in VP design that are necessary to promote professionalism.

METHODS

Sixty-five dental students participated in learning sessions that involved collaborative practice with five VPs (four high fidelity and one low fidelity), followed by reflection sessions. Students' perceptions towards the use of VPs in developing ethical reasoning skills were assessed using a questionnaire that involved 10 closed and three open-ended questions.

RESULTS

High-fidelity VPs were perceived as significantly better for developing ethical reasoning skills than low-fidelity VPs. Analyses of answers to open-ended questions revealed two new features that are specific for VPs intended for teaching professionalism, which are VP dramatic structure and how it should end.

CONCLUSION

VPs intended for teaching professionalism need to have high fidelity, follow a specific dramatic structure and should include multiple plausible endings. The use of VPs as part of a collaborative activity that is followed by a reflection session is perceived as an effective tool for the development of ethical reasoning skills in dental education.

How do educators in one New Zealand undergraduate Bachelor of Oral Health course teach and nurture professionalism?

INTRODUCTION

Research on integrated dental hygiene and dental therapy courses is scarce; studies reporting on how staff in these combined scope courses teach professionalism are even more scarce. This study aimed to partially fill these research gaps.

METHOD AND MATERIALS

In 2016, online surveys were sent to 34 staff members who taught into the integrated Bachelor of Oral Health (BOH) course at the University of Otago's Faculty of Dentistry; 13 were returned. Two focus groups were conducted with six BOH educators.

RESULTS

Aspects of professionalism were taught and nurtured in the formal curriculum, the clinic and the informal curriculum. In the formal curriculum, policies outlining the professional standards of behaviour expected of oral health practitioners and students in New Zealand and the Faculty were discussed. In the clinic, educators taught professionalism through modelling clinical skills, assessing students' performance and commenting on their reflective logbooks. In the informal curriculum, BOH teachers nurtured professionalism through discussions about standards of behaviour outside of the university. Role modelling was the most common method that participants reported they taught or nurtured professionalism in their students.

DISCUSSION

Professionalism is a complex concept that is taught and nurtured in a number of ways over all aspects of the course.

CONCLUSION

Oral Health educators need to maintain a high standard of professionalism when interacting with students and patients, as well as in public spaces, in order to model professionalism to their students.

Hybrid Tool for Assessment of Professionalism among Dental Undergraduate Students

CONTEXT

Of the several methods available for assessment of professionalism, there is still no consensus on an ideal tool for dental undergraduate (UG) students.

AIMS

The study aims to use a hybrid tool for assessment of professionalism among dental undergraduate students.

SETTINGS AND DESIGN

Cross-sectional design with purposive sampling.

SUBJECTS AND METHODS

All final year UG dental students participated in this study. Evaluation of knowledge about professionalism was through written test. Professional behavior of each final year student in a clinical setting was assessed with a prevalidated questionnaire of multisource feedback (MSF). The scores of written test and the MSF were calculated for each student. Data were analyzed to evaluate scores of knowledge and MSF scores as per assessor category. Correlation between knowledge scores and MSF was evaluated. Student perceptions were taken toward assessment of professionalism.

STATISTICAL ANALYSIS USED

Statistical analysis was done using descriptive statistics. Pearson's coefficient was used to determine the correlation between average knowledge scores and the MSF scores.

RESULTS

Knowledge scores were significantly more for female students (P < 0.05, t-test). Patients rated the students highest. Correlation between knowledge and MSF scores was found to be statistically significant (Pearson's correlation, P < 0.01). Students gave feedback that assessment of professionalism should be done from the beginning of the clinical years.

CONCLUSIONS

Evaluation revealed that knowledge toward professionalism correlated with the professional behavior implying association between knowledge and reasons for a particular action.

The Graduating European Dentist-Domain I: Professionalism

This position paper outlines the areas of competence and learning outcomes of "The Graduating European Dentist" that specifically relate to Professionalism. Professionalism is a commitment to a set of values, behaviours and relationships, which underpin the trust that the public hold in dental care professionals. Shortcomings within this domain are often responsible for patient dissatisfaction, concern and complaint-and emphasis is placed on the importance of embedding these values from an early stage within the curriculum.

Evaluation of an assessment system for professionalism amongst dental students

INTRODUCTION

Dental professionalism is an essential requirement to practice dentistry that covers both abilities and personal qualities. Therefore, a programme of assessment that promotes personal and professional development throughout the undergraduate dental education course is needed. This study aimed to develop and validate a system to assess dental students' professionalism based on a previously developed conceptual framework.

METHODS

Using the framework, an assessment programme was designed to encourage students to reflect on and explain their observed behaviours with appropriate feedback. The programme was panel-tested and then administered to a cohort of senior dental students. Internal reliability criterion validity and construct validity were evaluated quantitatively, whilst the usefulness of the programme was evaluated qualitatively.

RESULTS

Mean of student, staff and agreed grades was similar, and there were no floor or ceiling effects. All item-total correlations were >0.6 and Cronbach's alpha = 0.95 indicating acceptable internal reliability. All items correlated significantly with global ratings indicating good criterion validity. All hypothesized correlations were significant, and grades were not related to age or gender. Qualitative data produced three themes: assessment process, educational value and suggestions for improvement.

CONCLUSION

The assessment programme has good internal reliability and validity and suggests that basing an assessment system around the explicit theoretical model is a valuable educational tool.

Medical professionalism frameworks across non-Western cultures: A narrative overview

BACKGROUND

Medical professionalism is context-specific, but most literature on professionalism stems from Western countries. This study is about benchmarking of different frameworks on professionalism and interpreting the commonalities and discrepancies of understanding professionalism across different cultures. We need to study the cultural underpinning of medical professionalism to graduate future "global" practitioners who are culturally sensitive enough to recognize differences (and also similarities) of expectations of patients in various contexts.

AIM

This study aims at describing culture specific elements of three identified non-Western frameworks of professionalism, as well as their commonalities and differences.

METHOD

A narrative overview was carried out of studies that address professionalism in non-Western cultures in the period 2002-2014.

RESULTS

Out of 143 articles on medical professionalism, only four studies provided three structured professionalism frameworks in non-Western contexts. Medical professionalism attributes in non-Western cultures were influenced by cultural values. Out of the 24 identified attributes of professionalism, 3 attributes were shared by the three cultures. Twelve attributes were shared by at least two cultures, and the rest of the attributes were unique to each culture.

CONCLUSIONS

The three frameworks provided culture-specific elements in a unique conceptual framework of medical professionalism according to the region they originated from. There is no single framework on professionalism that can be globally acknowledged. A culture-oriented concept of professionalism is necessary to understand what the profession is dedicated to and to incorporate the concept into the medical students' and physicians' professional identity formation.

What does dental professionalism mean to you?

The Association of Dental Groups’ Undergraduate Bursary Award (Professionalism) is an annual award for undergraduate entries relating to professionalism in dentistry. It is open to all UK dental undergraduates, whether dentists, hygienists, therapists or clinical dental technicians, and has three prizes: gold, silver and bronze. The competition involves answering two questions: ‘Describe what the term “dental professional” means to you, ensuring that you cover each of the main domain headings?’ and ‘Describe a time and situation in which you have had to demonstrate dental professionalism and explain which aspect of the main domain headings were relevant in the circumstances?’ The 2016 Silver Prize was awarded to Danny Watts, and here we present his essay on what the term ‘dental professional’ means to him.

Professionalization in Pharmacy Education as a Matter of Identity

Little research exists on the formation of professional identity in higher education health programs. Such programs may approach the teaching, learning, and assessment of professionalism based upon a suite of attitudes, values, and behaviors considered indicative of a practicing professional. During this transition, professional identity formation can be achieved through student engagement with authentic experiences and interaction with qualified professionals. This paper examines the shift toward identity formation as an essential element of professional education and considers its implications for pharmacy curriculum design.

Study on self-assessment regarding knowledge of temporomandibular disorders in children/adolescents by Swedish and Saudi Arabian dentists

OBJECTIVE

To estimate the degree of self-assessed knowledge among dentists in Sweden and Saudi Arabia regarding temporomandibular disorders (TMD) in children and adolescents using a summative form of assessment and further to investigate the possible factors that may influence the self-assessed knowledge.

MATERIALS AND METHODS

A questionnaire survey covering four domains (Etiology; Diagnosis and classification; Chronic pain and pain behavior; Treatment and prognosis) regarding TMD knowledge was used. Out of 250 questionnaires (125 in each country) a total of 65 (52%) were returned in Sweden and 104 (83%) in Saudi Arabia.

RESULTS

Self-assessed individual knowledge was significantly associated to the level of actual knowledge among the Swedish groups in the domains Etiology; Diagnosis and classification and Treatment and prognosis (p < 0.05). However, in the Saudi Arabian groups a corresponding significant association was only found in the domain Diagnosis and classification (p < 0.05).

CONCLUSIONS

This study showed that there is a difference in the accuracy of self-assessment of own knowledge between the dentists in Sweden and Saudi Arabia. The Swedish dentists have a better ability to assess their level of knowledge compared to Saudi Arabian dentists regarding TMD in children and adolescents. This difference could be related to several factors such as motivation, positive feedback, reflection, psychomotor, and interpersonal skills, which all are more dominant in the Swedish educational tradition.

Perceptions of Turkish Dentists of Their Professional Identity in a Market-Orientated System

This study explores the perceptions of Turkish dentists of their professional identity and of the effects of market orientation in dentistry. This phenomenological study used a qualitative approach using a group of Turkish dentists, who were selected based on the principle of maximum variation. Four focus groups and 31 in-depth interviews were conducted. Forty-nine dentists were interviewed using a semi-structured form. The data analysis yielded three themes: ( a) dentistry as a business; ( b) dentistry as a profession; and ( c) professional status of dentistry in the health care system and in the community. The participants' statements reflected that the dominance of market mechanisms in dentistry inevitably forces dentists to adopt the characteristics of a businessperson and prevents them from fulfilling the basic requirements of professionalism. All participants explained that with the transformation of the dental care market, dentists have become a cheap labor force and have lost their professional autonomy. Our study has confirmed previous reports pointing out the conflict between dentistry as a profession and dentistry as a commercial operation. The study also showed that in Turkey, as a country experiencing rapid reform processes, dentists' control over their professional practices and identities has decreased.

Pairing as an instructional strategy to promote soft skills amongst clinical dental students

Training dentists today is challenging as they are expected to provide a wide range of dental care. In the provision of good dental care, soft skills are equally important as clinical skills. Therefore in dental education the development of soft skills are of prime concern. This study sought to identify the development of soft skills when dental students are paired in their clinical training. In this perception study, four open-ended items were used to elicit students' feedback on the appropriateness of using clinical pairing as an instructional strategy to promote soft skills. The most frequently cited soft skills were teamwork (70%) and communication (25%) skills. However, both negative and positive behaviours were reported. As for critical thinking and problem solving skills, more positive behaviours were reported for abilities such as to explain, analyze, find ideas and alternative solutions, and make decisions. Leadership among peers was not evident as leading without legitimate authority could be a hindrance to its development. If clinical pairing is to be used as an effective instructional strategy to promote soft skills amongst students, clear guidelines need to be developed to prepare students to work in a dental team and the use of appropriate assessment tools can facilitate the development of these soft skills.