Key Points
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Highlights the pressures facing general dental practitioners' engagement with CPD.
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Questions the effectiveness and quality assurance processes of CPD.
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Emphasises some of the potential problems with translational clinical research.
Abstract
Objectives To explore general dental practitioners' opinions about continuing professional development (CPD) and potential barriers to translating research findings into clinical dental practice.
Design Qualitative focus group and interviews.
Subjects, setting and methods Four semi-structured interviews and a single focus group were conducted with 11 general dental practitioners in North East England.
Outcome measure Transcripts were analysed using the constant comparative method to identify emergent themes.
Results The key theme for practitioners was a need to interact with colleagues in order to make informed decisions on a range of clinical issues. For some forms of continuing professional development the value for money and subsequent impact upon clinical practice was limited. There were significant practice pressures that constrained the ability of practitioners to participate in certain educational activities. The relevance of some research findings and the formats used for their dissemination were often identified as barriers to their implementation in general dental practice.
Conclusions There are a number of potential barriers that exist in general dental practice to the uptake and implementation of translational research. CPD plays a pivotal role in this process and if new methods of CPD are to be developed consideration should be given to include elements of structured content and peer review that engages practitioners in a way that promotes implementation of contemporary research findings.
Main
S. J. Stone, R. D. Holmes, P. A. Heasman, G. I. McCracken British Dental Journal 2014; 216: E23
Editor's summary
This research covers two familiar areas although not subjects that are usually combined; continuing professional development (CPD) and translational clinical research.
Rather like seat belts in cars, no smoking in enclosed public places and mobile phones, CPD seems to have been with us forever. In fact it is a little over a decade and yet it has, necessarily and quite rightly, become an inherent part of our daily lives. What this very focussed piece of qualitative research has done is to attempt to tease out the value that general dental practitioners (GDPs) find in different forms of CPD. When first introduced as mandatory the understandable rush was to accumulate the required number of hours in almost any way possible in the uncertainty of just how the system might work and in the imperative to ensure that one was not left behind.
With maturity and development in the systems and requirements so too has come a less frenetic and more considered way of approaching CPD, more along the lines in the original vision for personal development rather than merely spending time on random activities just to fulfil proof of hours undertaken. Evidence in this paper is supportive of this trend.
In terms of translating clinical research findings into practical actions in healthcare all practitioners are inherently sceptical. While the outcome of non-clinical experiments might prove that method A provides a measurably better outcome than method B; mixing two chemicals to provide greater yields perhaps, the benefit from clinical research is far less easy to unequivocally apply. This is because we deal with people; living biological beings rather than 'things' and on top of that, biological beings who express thoughts, feelings and emotions none of which might be predictable and certainly not always logical.
The summary of this is that in terms of communicating clinical dental research, and indeed in commissioning it, GDPs clearly appreciate the networking and association style of peer discussion and dissemination as well as involvement in its initiation. To this end the BDA's Shirley Glasstone Hughes Fund is perhaps a good example of how this can progress (www.bda.org/dentists/education/sgh/about_sgh.aspx).
The full paper can be accessed from the BDJ website ( www.bdj.co.uk ), under 'Research' in the table of contents for Volume 216 issue 11.
Stephen Hancocks
Editor-in-Chief
Author questions and answers
1. Why did you undertake this research?
The aim of translational clinical research is to bring about improvements to healthcare from research findings. Researchers need to understand the issues that are relevant to general dental practitioners so that their research remains relevant and the translational process occurs. Unless research is incorporated into clinical guidelines, investigators often have limited evidence that their work has true impact on healthcare delivery. The route through which this transfer of knowledge occurs is through the various methods of continuing professional development (CPD). It is important to understand how general dental practitioners engage with these activities and explore the barriers that exist to the implementing research into clinical practice.
2. What would you like to do next in this area to follow on from this work?
This study has highlighted the need for engagement with general dental practitioners and as key stakeholders in clinical dental research. Further work is required in the evaluating the impact of CPD delivery methods particularly if CPD is to form a significant component of the formal process of revalidation in the future.
Commentary
All UK dentists are required by the General Dental Council (GDC) to undertake continuing professional development (CPD) as part of their professional responsibilities and in order to remain on the GDC register. There are a variety of CPD providers and also a range of formats of CPD learning materials. This study investigated the role that CPD might play in enabling results from research studies to be translated into changes in day to day general dental practice.
Although this was a small scale study carried out in one particular area of England, the findings are interesting and give an insight into the reasons general dental practitioners choose different types of CPD.
Practitioners in this study acknowledged and appreciated the range of formats of CPD available to them, from taught postgraduate degrees to dental journals and online learning, which enabled them to make choices based upon their individual needs and constraints. The expansion of verifiable online learning was seen as positive in terms of cost and time; however, dentists had mixed views about whether this type of learning actually promoted change in behaviour or practise.
Within the pressured environment of general dental practice, dentists have to choose their CPD carefully from the profusion of options available. Personal development plans (PDP) have become an important tool to aid practitioners' decision making and it is encouraging to see that there is less of a scattergun approach to learning than in the early days of CPD.
Perhaps unsurprisingly, networking with colleagues emerged as an important vehicle for dentists to make sense of new information and for consolidating learning from postgraduate courses and conferences. The paper highlights how this informal mechanism is a crucial channel for bringing 'academic' information into the real world of dental practice.
A key question for clinical researchers is how to ensure their research findings are incorporated into the evidence base for dentistry and taken up by dentists in their practices. It is clear from this study that it remains a challenge, but one that might be tackled by closer involvement of dental practitioners at all stages of planning and dissemination of research projects. CPD is a vehicle that has the potential to facilitate these interactions but the challenge for providers will be to create learning environments which engage and stimulate primary care dentists.
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White, D. Summary of: Continuing professional development and application of knowledge from research findings: a qualitative study of general dental practitioners. Br Dent J 216, 640–641 (2014). https://doi.org/10.1038/sj.bdj.2014.479
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DOI: https://doi.org/10.1038/sj.bdj.2014.479