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The views of young dentists, both VDP and non-VDP, in their first year in dental practice were sought by means of a postal survey. The majority felt they had received guidance and support from their principals, though standards did vary widely across practices. Both groups had favourable views on vocational training.
The aim of this study was to compare the continuing professional development of young dentists who had participated in a vocational training scheme with that of young dentists who had not. It was encouraging to find both groups were actively involved in a broad range of continuing educational activities.
I am now drawing towards the end of my year in Eastbourne as a vocational trainee on the Brighton Scheme. Eastbourne is a busy seaside resort on the south coast. Rather a lot of 'grannies' reside there; but contrary to popular belief I do not spend all day, every day making and repairing dentures! The work is varied and interesting and I am spending a happy year consolidating my knowledge and becoming more confident at practising dentistry. Here are a few of the best and worst parts of the year.
'In the name therefore of the love of truth, in the name of the dignity of our profession, in the name of the good of all mankind, I implore you carefully to investigate this important subject.' So said John Elliotson on June 27, 1846. In 1984 in Glasgow, a very eminent dentist said, 'Everyone knows hypnosis is only so much mumbo-jumbo'! Fortunately this latter attitude is not shared by many of the profession and, in the forward-thinking of vocational training schemes, hypnosis is a subject which, it is felt, should certainly be covered.
Inspired by the coverage that the Vocational Training Scheme has been receiving recently, Josephine Drewett gives BDJ readers a rather different view of the life she chose to follow immediately after graduating from the University of Bristol Dental School.
Last year the Health Departments commissioned an independent 'scrutiny' of the organisation and management of the general dental service vocational training scheme. This was to prepare the ground for the introduction of a mandatory scheme. A report has been delivered and the interested parties are now considering the conclusions and proposals, which are summarised here.
January 1994 saw the start of a pilot second year VT scheme in the West Midlands combining house officer/GDP associateship experience as an integral part of general postgraduate training in dentistry. The scheme is funded by a grant from the W.M. Board of Postgraduate Medical and Dental Education. The availability of such a course in each region would be beneficial for those dentists who wish to experience hospital practice following their mandatory vocational training.
Many GDPs still look upon clinical audit with some scepticism, but there are clear benefits to be gained by GDPs from using audit within general practice. This article draws on the authors' own experience of the benefits that were gained by practitioners during a clinical audit session, as part of vocational training.
OBJECTIVES: The objectives of this course were: to develop an induction course for vocational trainees taking up first SHO posts; to enable new dental SHOs to have enhanced skills from the beginning of the post; to create safe practitioners capable of performing SHO duties; and to assess whether such a course is perceived to be beneficial by the SHOs, their educational supervisors and professional colleagues from medicine, dentistry and nursing. DESIGN: A 5-day intensive, interactive course was developed and directed by a consultant maxillofacial surgeon, with contributions from a range of professional colleagues to teach appropriate knowledge, skills and attitudes. SUBJECTS: Trainees completing the VT programme; due to commence SHO posts in the Yorkshire Region. EVALUATION METHOD: Detailed daily and end of course questionnaires were completed. A post course; in-work evaluation was sought from the trainees, educational supervisors and a range of professional colleagues about the validity of the course. RESULTS: Daily and end of course evaluations were positive about the perceived importance and relevance of the course. After 6 weeks in post the SHOs continued to place high value on the course as a preparation for hospital practice. Feedback from the supervisors and colleagues indicated that the SHOs were performing well, but the influence of the course on performance could not be determined in this study. CONCLUSION: It was possible to design and deliver an appropriate induction course, which appeared to meet most of the needs of new dental SHOs. Feedback indicated the need for modification of some aspects of the course.
Formal assessment of dental vocational training (DVT) has been an issue since 1993 when DVT became mandatory for graduates wishing to practice within the NHS. There have been a number of other drivers for change, including concerns about the capabilities of new graduates, a lack of standardisation of the training experience and accountability for standards of training. All of these factors contributed to the decision, by the Scottish Council for Postgraduate Medical and Dental Education (now part of NHS Education for Scotland--NES), to support a programme of research into the development of a competency-based system of assessment for DVT. During the life of this project the argument for introducing assessment of DVT and General Professional Training (GPT) has become ever stronger.
OBJECTIVE: To identify determinants of nutrition guidance practices of general practitioner-trainees (GP-trainees), to investigate whether these determinants differ from those found by experienced general practitioners; to reveal educational directions towards the development of computer-based instruction on nutrition. DESIGN: Cross-sectional study by means of validated questionnaires. SUBJECTS: All GP-trainees in training at the eight university departments for vocational training in the Netherlands in September, 1998 (n = 985). MAIN OUTCOME MEASURES: Reliability of determinants of nutrition guidance practices was calculated by means of Crohnbach's alpha. The mechanism of action of determinants was identified by means of linear structural relationship analysis (LISREL) using a model developed for GPs. RESULTS: Crohnbach's alphas for factors ranged from 0.58-0.90. The empirical GP-trainee-data fitted with the corresponding GP-model on the mechanism of action. CONCLUSIONS: The same predisposing factors, driving forces and barriers as found with GPs were identified with GP-trainees. Comparing the GP-and GP-trainee-models, only minor differences were found in the path coefficients between factors. Lack of nutrition training and education proved to be of great influence on the extent of nutrition information given. The GP-trainee-model will be of use in developing computer-based instruction on nutrition. It is expected that GPs may also benefit from this instruction.
Nurse education is currently undergoing major change. This article seeks to examine how National Vocational Qualifications (NVQs) are contributing to the future of nurse education. Criticisms of Project 2000 (P2K) include failure of the programme to produce nurses who are 'fit for practice' at the point of registration. A major criticism was that there is not enough skills-based training included. Following a recent report, recommendations were made which included a move to introduce a competence-based approach in nurse education. This approach is becoming more evident in both pre- and post-registration nurse education. A mapping exercise demonstrated that many of the UKCC competencies for pre-registration nurse education could be mapped to care NVQs. The article concludes that the positive aspects of care NVQs and P2K education should be embraced to enable programmes of nurse education to prepare nurses who are 'fit for practice'.
The assessment of capability of work consist of measuring the patient subjective willingness to perform and his efficiency which should be objectively examined by functional diagnostic tools. On the one hand, there is the consideration of the patients psycho-mental burdens and on the other hand has to be defined the extent of organic functional restrictions. The latter is difficult to assess because diseased organs of the gastrointestinal tract are not directly involved in the efficiency of work. In chronic diarrhea purely watery diarrhea causes mobility restrictions at the place of work. In case of chronic malabsortive diarrhea, psycho-mental and physical deficits of efficiency have to be taken into account. The latter however may be almost restored by adequate substitution of macro and micro nutrients. For the clinical assessment of the severity of incontinence and ist psychosocial effects structured history sheets and working up of clinical findings and specifics function tests are necessary. The so defined degree of stool incontinence determines the restrictions of vocational efficiency. Generally persons with stoma are nearly not disabled and capable of gainful employment. This also pertains to professions with specific hygienic requirements, such as a production and distribution of foods. Persons with well applied and provided stomata should avoid severe physical burdens, unsuitable postures and periodical forms of labour like piece-work.
This study of educational encounters between a trainer and a trainee in vocational training for general practice investigates the quality of the encounter. The study focuses on the relation between the quality of the encounter and elements such as presence of feedback, duration, use of media, etc. A quality measure based on the Gagné and Briggs model for the design of instructional events was developed. The quality score was correlated with other elements of the encounter as reported in a log diary completed by trainees. In the log diary 45 trainees registered 314 encounters. Quality predictors included duration of the encounter, the number of media (files of patients, professional guidelines) used, the number of follow-up activities and feedback by the trainer on the performance of the trainee. Several elements were identified as contributing to the educational quality of the encounter, such as presence of media, follow-up activities and positive feedback. The trainer can easily control these elements.
OBJECTIVES: To investigate the prevalence of back pain in a general population aged between 20 and 59 years. POPULATION: A representative sample of 2000 individuals from Ostergotland County, Sweden (population 400,000). STUDY DESIGN: Cross-sectional study using a questionnaire including the pain drawing. RESULTS: The observed point prevalence was 28% (95% confidence interval 26-31%). The adjusted prevalence taking into account the non-responders was 23% (21-25%). Lumbar pain with radiation was reported by 40%, while 4% had only cervical pain with radiation. Twelve per cent were on sick-leave due to back pain. Activity of daily life was affected mainly in the group of men aged 40-59 and only in household tasks. The back problems did not affect social activity. CONCLUSIONS: The prevalence of back problems in the vocational ages was found to be 23%. Only small parts of a pain population are on sick-leave or have changed working tasks because of back problems. The distribution of pain in most cases is combined with radiation to extremities and not isolated to a single region. The combination of different localisations shows the pain problem to be more than just a "low back" problem.
In 1986 an educational program in Oncology for General Practitioners was developed at the University of Amsterdam. This program will be implemented within the general practitioners' vocational training. In this program the various goals of the general practitioner have been categorized: prevention; diagnosis by the general practitioner; diagnosis by the specialist; therapy; and guidance and care. All these goals have been further subdivided in more concrete skills to give form to the various aspects of the task of the general practitioner. These skills have been related to the different types of cancer. A number of related skills will be illustrated in the program for a specific type of tumor. Hence, a so-called basic educational program is formed. The various basic educational programs, in which different types of tumors are used for illustration, consist of program-units of 90 minutes. Relevant aspects of specific types of malignancy, which are not dealt with in the basic educational program, will be added to the basic educational program as supplements.
This essay argues for a renewed institution of an ancient Christian practice, the Order of Widows. Drawing on the Roman Catholic tradition's recent writings on the elderly, particularly the 1998 document from the Pontifical Council for the Laity entitled "The Dignity of Older People and their Mission in the Church and in the World," I argue that we find within the Roman Catholic tradition advocacy for a renewed understanding of the vocation of the elderly within the Church. Building on this, I then trace in the broadest of outlines some elements of what a renewal of the Order of Widows might look like. In doing so, it becomes clear how this new ecclesial practice addresses health issues of older women (devaluation, marginalization, loss of voice, impoverishment, debilitation, loneliness, isolation, and euthanasia). More importantly, such a practice moves beyond principles to demonstrate a concrete alternative. As such it would provide a powerful witness to the very culture the Church seeks to transform.
The incorporation of a module of public health teaching into a general practice vocational training programme is described. This programme is itself innovative in that in addition to the 2 years of hospital-based training, it provides 2 years of community-based training. While the curriculum of the public health module is evolving with time, the objectives have remained the same, and are being met. The module has been appraised by external observers, and has been evaluated by participating trainees. The public health module is now an established feature of the Sligo general practice training programme.