Informing Research in Primary Dental Care: Setting Priorities

Developing a national dental education research strategy: priorities, barriers and enablers

OBJECTIVES

This study aimed to identify national dental education research (DER) priorities for the next 3-5 years and to identify barriers and enablers to DER.

SETTING

Scotland.

PARTICIPANTS

In this two-stage online questionnaire study, we collected data with multiple dental professions (eg, dentistry, dental nursing and dental hygiene) and stakeholder groups (eg, learners, clinicians, educators, managers, researchers and academics). Eighty-five participants completed the Stage 1 qualitative questionnaire and 649 participants the Stage 2 quantitative questionnaire.

RESULTS

Eight themes were identified at Stage 1. Of the 24 DER priorities identified, the top three were: role of assessments in identifying competence; undergraduate curriculum prepares for practice and promoting teamwork. Following exploratory factor analysis, the 24 items loaded onto four factors: teamwork and professionalism, measuring and enhancing performance, dental workforce issues and curriculum integration and innovation. Barriers and enablers existed at multiple levels: individual, interpersonal, institutional structures and cultures and technology.

CONCLUSIONS

This priority setting exercise provides a necessary first step to developing a national DER strategy capturing multiple perspectives. Promoting DER requires improved resourcing alongside efforts to overcome peer stigma and lack of valuing and motivation.

Orthopaedic trauma research priority-setting exercise and development of a research network

INTRODUCTION

Clinical practice should be informed by high quality evidence, of which randomised controlled trials (RCTs) are considered the gold standard. Surgical trials are inherently difficult with potential problems around clinical equipoise and participant acceptability. This is often most true with trial designs comparing operative and non-operative treatments. It is hoped that research activity can be maximised by collaborating in (a) the identification of research questions and (b) involvement in clinical trials. Development of the national research networks can be utilised to provide support for research endeavours within the orthopaedic trauma community.

AIMS

To identify and prioritise the research questions felt to be of most importance by the orthopaedic trauma community. Research studies will be considered for questions given the highest priority.

METHODS

A Delphi approach was used to determine consensus between the faculty members of the AOUK. A two round process was used to elicit the research questions and then to rank them in order of priority.

RESULTS

217 members of the AOUK Long Bone Faculty were asked to submit research questions, predominantly consultant orthopaedic surgeons. A 22% response rate generated 147 questions. These were collated and the most frequent 24 sent back out for ranking by mean scores. A 55% response to this second round identified 10 top questions. Literature searches for these 10 looked at current knowledge of the subject, completed and ongoing research projects. We also looked at the advantages and disadvantages of undertaking a study and the most appropriate methodology.

CONCLUSION

The response rates demonstrated a clear interest in developing a collaborative research strategy. This can be enhanced by utilising the support of the National Institute of Health Research Clinical Research Networks (NIHR CRN).

Managing resources in NHS dentistry: the views of decision-makers in primary care organisations

OBJECTIVE

To investigate priority setting and decision-making in primary care organisations and to determine how resources are managed in order to meet the oral health needs of local populations.

METHOD

This is a qualitative study. The purposive sample comprised twelve dental public health consultants and six senior finance representatives from contrasting care systems across the United Kingdom. Participants completed a written information sheet followed by a recorded semi-structured telephone interview. Conversations were professionally transcribed verbatim and analysed independently by two investigators using the constant comparative method.

RESULTS

The emergent themes focused upon: the role of participants in decision-making; professional relationships; managing change; information needs; and identifying and managing priorities. There was wide interpretation with respect to participants' roles and perceived information needs for decision-making and commissioning. A unifying factor was the importance placed by participants upon trust and the influence of individuals on the success of relationships forged between primary care organisations and general dental practitioners.

CONCLUSION

To facilitate decision-making in primary care organisations, commissioners and managers could engage further with practitioners and incorporate them into commissioning and resource allocation processes. Greater clarity is required regarding the role of dental public health consultants within primary care organisations and commissioning decisions.

An initial analysis of the research competency level of the Faculty of General Dental Practice (UK)'s Divisional Research Contacts. An in-house survey

PURPOSE

The purpose of this survey was to identify the current level of competence of the Faculty of General Dental Practice (UK)'s [FGDP(UK)'s] Divisional Research Contacts (DRCs).

METHODOLOGY

The FGDP(UK)'s DRCs were each sent a copy the Faculty's Research Competencies Framework (RCF). A mutually convenient time for a telephone interview was then agreed between the DRCs and one of the Faculty's two National Research Facilitators. During the interview, a structured questionnaire was used and the DRCs' qualifications and research experience were recorded along with their perceived knowledge and skill levels for each of the 21 competencies in the RCF, using a five-point Likert scale.

RESULTS

Eighteen of the 20 DRCs were interviewed, of whom 12 either possessed or were studying for higher research or partresearch degrees (PhD or MSc). All had some previous research experience. For 11 of the 15 competencies in the four domains of practical skills, problem-solving, attitudes and dissemination, DRCs rated their knowledge and skills levels as average or higher. For two of these 11 competencies (communication skills and understanding the need for research to support clinical practice), all 18 DRCs rated their levels of knowledge and skills as good or excellent. In the domain of roles and functions, DRCs rated their levels of knowledge and skills at a lower level. Seven rated their competence in designing and implementing a series of studies that address a significant issue and in writing research funding applications to major bodies as poor or very poor.

CONCLUSIONS

The present survey has provided the basis for a future, in-depth training needs analysis along with an insight into the research competency level of 18 of the Faculty's 20 DRCs.