By Marina Bozic and Ewen McColl

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©The Good Brigade/DigitalVision/Getty Images Plus

Introduction

Peninsula Dental Social Enterprise based in the South West of England employs dental nurses in a wide range of roles and utilises dental nurses' full scope in order to optimise outcomes for patients. Peninsula Dental Social Enterprise (PDSE) was created in 2013 and provides a 'corporate' structure for the management and development of the fabric of the dental learning clinical environment, the structure for a consistent and sustainable community engagement programme, and a vehicle to manage clinical and professional governance.

PDSE works closely as the clinical delivery arm of Peninsula Dental School, University of Plymouth. There are four large Dental Education Facilities (DEFs) in Plymouth (Devonport and Derriford), Truro and Exeter under one umbrella where students from the university treat NHS patients under supervision, alongside providing dental treatment and outreach services to local communities. PDSE is a Social Enterprise Community Interest Company (CIC) and it is the only model of its type supporting a university dental school in the UK.1,2 As a CIC, everything it does is guided by its community purpose to which its assets and profits are dedicated.

Dental nurses within the organisation contribute to direct support of clinicians, act as clinic team leaders, support student clinics, radiography, clinical governance management, support postgraduate teaching and clinical delivery, coordinate clinical research, and lead on Outreach teaching and support of the British Antarctic Survey Medical Unit.

In this paper, we describe the role of a research dental nurse in a large primary care facility, and the journey through an industry-sponsored research trial.

Personal motivation for research involvement

This section is taken from the National Institute for Health and Care Research (NIHR) case study.3

Qualifying in 2016, Marina (the co-author of this article) began her career as an apprentice, studying at King's College London and practising in Hitchin in Hertfordshire. She moved to the South West in 2021.

Marina says: 'I've always liked being involved with patients and being able to change their life through their smile. Now I work sometimes with students, and sometimes in surgery. It's really interesting because PDSE runs a range of different projects - we help people that are homeless, for example, there's a refugee clinic and a kids' clinic.'

Although thoroughly enjoying her clinical role, Marina was keen to get involved in research when the opportunity arose.

'One of my teammates began working in research as part of her job, and I thought it looked really interesting. Then a role was advertised internally for a research dental nurse, so I applied and was successful. I'm currently doing one day a week alongside my other duties.

'I've been involved in research several times as a participant, and I was always interested in how the studies worked and what the staff were doing beyond the appointment with me. Getting involved in research enhances my career portfolio and I am learning a lot about clinical trials and working with a wider team of other professionals beyond dentistry.'

Marina, though, believes the benefits of research go well beyond individual career development.

'For patients, taking part in research makes them feel as though they are valued and their opinion counts, and they have participated in something bigger. It can be a real motivation for people who might be struggling. We see this especially with the homeless clinic; it is a really positive thing for them to feel they have participated in something that could change people's lives.

'Everyone can get into research, there are so many opportunities, especially as we involve more and more people and primary care sites, not just hospitals. I think research is a really good opportunity for dental nurses. Most people choose our profession, not for the money, but because they want to help patients, and research is definitely one of the ways dental nurses can do that.'

Journey through an industry sponsored clinical trial

National Institute for Health and Care Research (NIHR) Clinical Research Network, South West Peninsula alerted us to the industry sponsored trial and we applied to be a study centre in this global multi-centre trial. Our application was successful and after complying with all the governance requirements including Good Clinical Practice (GCP) training arranged via NIHR we commenced planning for the trial with the research nurse's role to coordinate the organisation, logistics and planning of the trial.

Planning

Knowing who to ask and where to look for information is important in the planning stages of any research trial. Thankfully NIHR CRN are very helpful for dental team members who want to be involved in research. Their support and guidance were essential to the success of our involvement in this research trial.

Most people choose our profession, not for the money, but because they want to help patients, and research is definitely one of the ways dental nurses can do that.

Meticulous preparation is one of the most important steps and in research the adage 'Failing to plan is planning to fail' is very true. Getting familiar with the requirements of the trial is a good starting point. Reading the protocol of the study several times helped with this process as well as reviewing the protocol with all team members present. Having people in the right places, delegating where appropriate, and following up on delegation is also an important part of the preparation for a trial. Getting the team together prior to study commencement and practising the walk-through before we see the first patient will flag up any likely issues and allow changes to be made prior to patient visits.

Tracking all the work involved and logging all the processes is critical for a well-managed research study.

Recruitment

During recruitment, we noticed that people are often willing to participate in research and understand the importance and long-term benefits of the research. They understand that half an hour of their valuable time can potentially make a big difference in someone else's life. This trial was investigating contributory factors to oral cancer and one of the participants had a sister who sadly died from oral cancer, and that participant wanted to contribute to the study to help others, and in memory of her sister.

Delivery - challenges

This study relied on the participants to turn up for their routine dental appointments, so coordinating their appointments alongside the research component required good planning, flexibility of planning, and coordination with other team members (Fig. 1).

Fig. 1
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The trial commences (Marina Bozic is pictured)

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Recording data on the research data input system had preliminary issues, however, the study coordinating team resolved this issue and communication was key in resolving any issues. For some patients who required a follow-up call, we made phone calls between seeing patients and at the end of the day, so this did add to workload, but a supportive management team helped in balancing the research component with other responsibilities.

Involvement in dental research is rewarding on a number of levels. Many of the skills dental nurses employ on a daily basis are readily transferrable to research.

Completion

Samples were sent to the USA for analysis on the last day of recruitment and again organisation of the logistics was a key role of the dental nurse (Fig. 2).

Fig. 2
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Final sample collection packed in dry ice ready for the flight to USA

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Conclusions

Peninsula Dental Social Enterprise is a unique and innovative module of clinical delivery and clinical education. Every staff member is encouraged to optimise scope to not only promote an interesting and varied work pattern, but to optimise outcomes for patients.

Involvement in dental research is rewarding on a number of levels. Many of the skills dental nurses employ on a daily basis are readily transferrable to research. These key skills include good communication skills, organisation, leadership, team working, problem solving, and patience, to name but a few. Whilst hard work, the rewards are great in contributing to scientific knowledge and hopefully helping a larger number of patients.

Acknowledgements

The authors would like to thank all PDSE staff for their contribution to the delivery of PDSE projects.

Special thanks to Professor Robert Witton as Chief Executive of PDSE & Director of Community Based Dentistry, Peninsula Dental School.

Rebecca Anderson - Governance and compliance manager

Marie Shearman RDN, RAD - Clinic Team Leader

Dental nursing and reception team of the Devonport Site of PDSE

NIHR CRN SW Peninsula Team