Talk to any professional in the world of training and education, and they will tell you that it has been a constantly changing one for some years. Even the government department with responsibility for ensuring a literate, educated, skilled population and workforce moved from being the Department for Education and Science to one for Education and Skills. The language of education and training has also shifted in the last ten years, and two of these major shifts are now having a significant effect on dentistry.

The first major change is from talking about training to talking about learning. The government's lifelong learning agenda set this tone at a national level. The emphasis has shifted from training to how effectively people have learned. Training can be irrelevant if no learning has taken place, and different ways of measuring learning have been explored and examined at length.

The second major change is the focus on the outcomes or results of education, training and development rather than the process by which it has been carried out. The greatest example of this is the rise of the Investors in People standard (IIP), which has been taken up in the last three years or so with increasing alacrity by dental practices as a valuable, effective means of developing their businesses. At the heart of IIP is an objective approach to training which means that all training and development is measured for its effectiveness in helping the business to grow and develop.

The full effects of this 'double whammy' have yet to be felt in dentistry, but the recent introduction of the NVQ levels 2 and 3 in oral healthcare is the beginning of a new approach to learning and assessment which combines both of the approaches set out above. National Vocational Qualifications (NVQs) have been in existence for some years in many areas, and are generally regarded as a useful and effective way to assist people to learn, develop skills and demonstrate competence. The days where competence is tested purely by an examination at the end of a period of study (a three year degree course in my own case) are fast disappearing. NVQs are awarded across a range of subject areas, but stand for the same thing – recognition that an individual is competent to carry out all of the aspects of a particular job or function.

The other important aspect of NVQs picks up on the shift from education to learning; for many, there is an understanding that in vocational training, learning takes place most effectively on the job. This might be underpinned by an external course, but again we have to consider the value of this carefully. If our aim is to ensure that a learner or trainee is competent, then there may be areas of the job which they learn quickly and require no additional training to carry out. NVQs recognise this, and the need for training to be tailored to the individual learner. All NVQ programmes should therefore be preceded by a development needs analysis for the individual. What can they do already, and what do they need to know? By carrying this out, the trainer, or dentist, knows that all the training they are giving is relevant; the 'conveyor belt' approach to training where all learners are taught exactly the same, regardless of their level of ability and knowledge at the outset starts to seem inappropriate.

The NVQ system also recognises that the best people to assess competence are often those in the workplace already – dentists, nurses and other PCDs. The system built up over many years to ensure quality control can just as easily be applied to dental practice as to any other business. In fact, the requirements of the new oral health care NVQs are that suitably dentally qualified people are the ones to carry out assessment.

It makes sense for the profession to embrace a means of ensuring that the training that they carry out is to a clear standard...

What does this mean in practice? To begin with, dentistry may need to embrace some new ideas about training, learning, development and the assessment of competence. These ideas are not new, but are new to parts of the profession. The main thrust of the new approach to dental nurse training and qualification is about having competent professionals supporting the dentist, and ensuring that the quality of training provision, however and wherever it is carried out is rigorous and standardised. A lot of training currently happens in practice as it is not otherwise available for the trainee nurse due to time or location. It makes sense for the profession to embrace a means of ensuring that the training they carry out is to a clear standard, and to better meet modern thinking in training and development.