PubMed · 11011377
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W W Gibbs. 2000. Speech without accountability.. https://doi.org/10.1038/scientificamerican1000-34
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INTRODUCTION: This paper describes a Thematic Network Project (TNP) funded by the European Union's Directorate for Education and Culture. It focused on convergence towards higher standards in dental education in the European Union and included those 'Associate Countries' seeking membership of an expanding EU. The DentEd Project sought to use peer influence in promoting convergence towards higher standards in European dental education and training. There is evidence of serious differences in standards despite the European Union's Dental Directives and the series of guidelines and recommendations of their Advisory Committee on the Training of Dental Practitioners. METHODS: The DentEd TNP sought to improve communication, better understanding of different systems and to pool intellectual resources. A central objective of the network was to promote outcome analysis and the implementation of evidence-based treatments. DentEd sought to identify and disseminate innovations and best practices in European dental schools and stomatological institutions. This was achieved by instigating 30 self-assessments of dental schools throughout Europe. Self-assessment was followed by a visit from a team of international peers. Each assessment comprised 19 sections and was placed on the DentEd web site (www.dented.org) after it was jointly approved by the visitors and host school. The 30 self-assessment reports together with the visitors comments and recommendations were then divided into their component sections and analysed. Responsibility for each section was allocated to one of 19 different international working groups of between 8 and 12 people. Preliminary analyses from these working groups were presented and debated on the DentEd interactive web site. They finalised their findings in the DentEd Report at a Plenary meeting in the Nobel Forum in the Karolinska Institute in Stockholm. The meeting was organised in such a way that each working group finalised their report. This was followed by the rotation of the working groups to listen and respond to the presentation of another group on the basis of a series interactive meetings. At the end of the meeting the original groups reassembled and revised their analysis on the basis of the additional input from the other 200 individuals involved and then finalised their group's report on the web site. These reports are available on the web site and were also published in hard copy.1 The three-year DentEd Project achieved its stated objectives. CONCLUSION: The DentEd Thematic Network Project employed a process of schools visits, plenary meetings and the use of an interactive web site to help reach consensus on innovations, best practices and significant divergence in standards in dental education in Europe. This process has proven an effective method of improving communication and of increasing the understanding of diversity in a wide range of educational methods. It also emphasised the importance of continuing quality improvement and outcome analysis of the clinical competence of graduates from European dental schools. It is important to emphasise that schools visited are likely to reflect those with an open and flexible attitude to educational reform and development and perhaps they were not representative of those schools that would benefit most from a self-assessment followed by peer review. On completion of the DentEd Thematic Network Project (TNP) the European Union's Directorate for Education and Culture approved a new three-year DentEdEvolves TNP and the consortium has recently submitted a major proposal in the EU's eLearning initiative on the basis of the success of this collaboration. This has extended to include 75% of dental schools from North America and plans for extension to South-east Asia will bring a major meeting to Singapore in April 2002.
This paper argues that the general public is, and should be, an important source of activity in end-of-life care reform. Two roles for the public are described: personal advocacy and public activism. The first relates to the role of private citizens in advocating on their own or a loved one's behalf at the end of life to secure quality palliative care. The second relates to the role of leaders in mobilizing reform efforts on behalf of the larger society. These roles overlap and often function to bolster one another. Numerous examples of how advocacy often transforms into activism and how activism relies on advocacy are given, drawn from the experience of directing Community-State Partnerships to Improve End-of-Life Care, a national program housed at Midwest Bioethics Center in Kansas City, Missouri.
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