Main

Aspects of the dental vocational training experience in the South East of England L. B. Cabot, H. M. Patel British Dental Journal 2007; 202: E14

Editor's summary

The vocational training (VT) year provides a crucial transitional period between the university environment of dental student life and the professional world of the general dental practitioner. While such a period of supervised practice prior to registration is not considered necessary in other parts of the world, as highlighted in last issue's Editorial (BDJ 2007; 202: 173), in the UK it is generally considered to be an essential part of dental training. However, there is little published research into the experiences of vocational trainees and their trainers and whether they find the VT year to be successful and worthwhile.

Cabot and Patel aim to partially redress this balance by determining the 'lived experience' of VT for vocational dental practitioners (VDPs) and their trainers. Their results are encouraging, since they illustrate that VT is largely considered a success by both trainers and VDPs. None of the VDPs in the study would have wanted to enter general dental practice without it and the VT trainers for the most part felt that the VT year achieved its aim of turning novices into competent dental practitioners. These conclusions agree with those of Clow and Mehra, who evaluated VT in three different regions (BDJ 2006; 201: 774–778). It is reassuring that research is finally providing evidence for what was always believed, but never before proven: that VT is a vital part of dental education.

One interesting finding in both papers was the attitude of VDPs towards the professional development portfolio (PDP), the document where they keep a record of their tutorials and undertake self-assessment. VDPs appear to find the PDP tedious and a waste of time and Cabot and Patel also show that trainers do not always use it as they should. Yet the PDP is the first step on the road of continuing professional development and if used properly, should be an extremely useful tool for VDPs to begin to use and understand reflective practice. This is a small but important area where improvement and encouragement could reap rewards for VDPs in future.

The full paper can be accessed from the BDJ website ( www.bdj.co.uk ), under 'Research' in the table of contents for Volume 202 issue 5.

Rowena Milan, Journal Editor

Author questions and answers

Why did you undertake this research?

Dental vocational training (VT) in the United Kingdom aims to transform the novice dentist into a competent general practitioner. But VT is a profound change for the new vocational dental practitioner (VDP); the expanded and overt environment of the university and the compact and comparatively clandestine world of general practice are very different learning environments.

Essentially this qualitative work was undertaken to determine what actually happens in VT; to describe the lived educational experience of VT for both VDPs and their trainers. There is still little evidence to support Seward's claim1 that VT has been the profession's success story. Indeed Baldwin et al.2 commented:

'It is remarkable that no formal independent assessment of the value of VT [has ever been] carried out in terms of educational worth or patient care.'

This work directly addresses Baldwin's concerns.

What would you like to do next in this area to follow on from this work?

This work strongly suggests that VT is a success for VDPs and it is a success for trainers. The next stage, which the authors are exploring at the present time, is to determine why VT is successful in educational terms.

It is reasonable to surmise that the teaching expertise of the trainers will have an impact on the success of the VT year. But what is the impact of that expertise, particularly in terms of providing the VDPs with positive role models? Is it possible to provide a list of attributes that the expert trainers exhibit that can provide a guiding path to success in VT?

Comment

The earlier part of the article is factual information about the structure, the process and the ethos of vocational training (VT). It makes good reading for those who are not well acquainted with the concept of VT. The article has briefly covered the significance of the study day, the practice tutorial and the professional development portfolio. The methodology of the research questions was set out to appreciate what 'actually happens in vocational training'.

The results of the research are expressed in terms of percentage of all the questions that were raised in the enquiry. The results make interesting reading and highlight some of the shortcomings in the undergraduate training. For specific issues, like prosthodontics, it is common knowledge that the dental schools do not have enough suitable patients to give competency to the dental students. It would be pretentious to say that after graduation the dental student will be competent in all the disciplines of dentistry. Proficiency and competency is not a destination one arrives at, but a manner of travelling.

The article is a good historical record of the experiences of the VDPs under the contract before April 2006. Under the new GDS contract, I am sure that the vocational training experience would be significantly different. Vocational training in the past was solely an educational experience, but under the new contract there is an additional dimension, of service provision, attached to it. It is a pious hope that the VDPs, with one eye on the UDA target, would be undertaking advanced restorative cases involving multiple disciplines.

It is my understanding that the London Deanery is going to undertake its own assessment of the VDPs experiences following their VT year. As the sample size of the Deanery assessment would be far greater, their findings will be a better reflection of the VDP experiences in the South-East of England.

On the positive side, this article will spur others to do more in-depth research on the subject of experiences and value of vocational training. It is simply not good enough to state that VT is 'a jewel in the crown' for dental training, without giving hard evidence for that statement.