State of the art

When registration becomes a legal requirement next year, PCDs must ensure they are qualified to do their jobs. Kathryn Marshall looks at new software that will make learning these key skills easier.

The General Dental Council was recently granted powers by Parliament to take forward mandatory registration for dental nurses. April 2006 has been scheduled for this momentous move for Professions Complementary to Dentistry (PCDs), after when the GDC will hold two registers, one for dentists and one for PCDs.

This new legislation will mean that to work as a dental nurse in the UK it will be necessary to have a qualification that is recognised by the GDC, or be on an approved training course. When the register opens there will be a two-year window where dental nurses who do not have one of the recognised qualifications may apply to the register and hope to gain entry through experience and evidence of competency as defined by the GDC. The title Dental Nurse will be reserved by law for those nurses who become registered.

When the register opens we know that those working as dental nurses who have had four years full-time work experience in the past eight years or part-time equivalent may apply to the GDC for inclusion. This transition period will be open for two years only. After this time the only way to register will be by holding a recognised qualification.

However, a series of road-shows around the country run by the GDC to inform the profession of the coming changes, found that many nurses would not be able to fulfil these criteria. It is important that dental practices do not lose these valuable team members.

Art

This is where Access to Registration (ART) has been meeting the challenge. It was launched earlier this year to deliver the underpinning knowledge in the six areas of competence required by the GDC's regulations (see Panel 1). With the help of European Social Funding through the Learning and Skills Council, Kent, Surrey and Sussex Deanery have been pioneers of ART and were responsible for the development of this programme.

Box 1: Panel 1: Six areas of competence required by the GDC

• Health and safety

• Infection control

• CPR, medical emergencies, and common dental emergencies

• Personal Development Plans, reflective learning, and CPD skills

• Working with dentists and patients

• Ionising radiation

Feedback has told us how important and useful this core training has been for dental nurses who have never received any formal instruction. Many of the course attendees have worked in dental practice providing essential assistance to dentists at the chair side but without the important theory behind the practice of the tasks they do every day.

Since March 2005 two groups of dental nurses have completed the six modules in Kent, Surrey and Sussex and have gained their certificates of competence ready to present to the GDC together with their evidence of a minimum of two years chair-side experience.

The ART programme is available free to other postgraduate deaneries and training organisations. So what is happening in the rest of the country? How many other dental nurses have been using the programme to bring them up to date ready for registration?

In the other 16 Deaneries in the UK only a handful that responded are making some effort to use this training package. But we know there are a vast number of dental nurses who really need to demonstrate their competency to provide an improved standard of care for patients and to develop a better career pathway for themselves.

Experience with ART so far has shown us the difficulty some dentists have in releasing their dental nurses to attend off site training days. Part of the problem is that it has been difficult at times for dental teams to balance the need for essential education without interruption in the delivery of care to patients. Despite the courses being available at several locations on various dates, it has been realised that some nurses will need to study using a different mode of delivery.

Enter DNART

Screen shots from the new DNART CD-ROM based training programme.

In the past two years the healthcare consultancy Smile-on Ltd have produced DNNET, a software teaching programme that provides the learning material needed for the NVQ in Oral Healthcare (Dental Nursing) and the National Certificate of the National Examination Board for Dental Nurses. It was decided to combine this programme with ART to produce DNART.

DNART was commissioned by COPDEND (The Committee of Postgraduate Dental Deans and Directors) and funded by the Department of Health.

Screen shots from the new DNART CD-ROM based training programme.

So how does it work? The CD-ROM based training programme can be used by any dental nurse with access to a computer whether at home or in the dental practice.

For nurses to get the most out of DNART it is recommended that a blended learning approach is used. This is a mix of lecture/tutorial sessions with the e-learning programme. Dental nurses can work through the programme on their own, but it would be much better if they were able to attend some classroom sessions with others so they were able to exchange experiences and learning initiatives.

Screen shots from the new DNART CD-ROM based training programme.

A special version of the programme for tutors is also being produced to assist trainers to deliver the course. This will be particularly helpful in situations where a dental nurse is not able to get access to a computer. The tutor version has PowerPoint presentations with links to the e-learning programme, student handouts, assessment questions and certificates. The tutor version is not reproducible, and is only available to accredited training organisations such as deaneries, dental schools and City and Guilds and National Examining Board for Dental Nurses training centres.

Like ART, DNART does not give a qualification but is designed to be a stepping stone to the NVQ in Oral Healthcare (Dental Nursing) at level three and actually gives the knowledge and understanding needed for six of the current nine mandatory units in that qualification. It is also an excellent learning resource for all members of the dental team wishing to update their current knowledge. The programme for dental nurses to use will be sent to every NHS dental practice free of charge in England and Wales in early September. Should accredited tutors want the special tutor version they will be able to apply to the KSS Deanery who will send the first copy for free but charge a small fee for further copies.

Future perfect

When dental nurses have registered can they sit back and relax? Probably not; all PCDs including dental nurses will be responsible to the GDC for practising within the limits of their competence. Dentists will of course remain the team leaders and will be responsible to the GDC for making sure they do not ask team members to perform tasks that are beyond their training and skills. Clear guidelines will be issued to dentists and all classes of PCDs on their roles and responsibilities.

Although the GDC will not commit to when and how much, mandatory continuing professional development (CPD) will follow for all classes of PCDs. But this will mean more training and education and the costs associated with it. With a registered qualification will come responsibility and a new level of professionalism. Just as dentists are subject to compulsory CPD to stay on the register all classes of PCDs will need to embrace ‘lifelong learning’ and keep their skills and knowledge up to date.

See Box

Box 2: Case Study: ART helps nurse build career

A dental nurse who has benefited from ART is Emma Maskell from Sussex. She works in a busy single-handed dental practice in Hove. When she began ART in March 2005 she had worked as a dental nurse for only a few months. She has a background in science, has been studying a foundation course, and worked for the past two years. Twenty two year old Emma's previous job was as a postal worker.

She decided on a career in dentistry because she was looking for a healthcare role in which she could hopefully advance and increase her knowledge base.

After a few weeks as a dental nurse she decided that she had made a good move and would like to begin some training. Information on which course to do and how to fund it was a challenge.

There was often conflicting advice on the best plan of action that would not compromise her duties, patients and colleagues but still fulfil her training requirements. However her dentist Mr Garland was keen for her to study and willing to support her financially.

The practice had recently received information about ART courses in their area from the Kent, Surrey and Sussex Deanery.

Emma decided to go to Chichester hospital to do the six module ART programme. Along with nine other student nurses with varying levels of experience but no formal qualification, this was Emma's introduction to the theory behind the daily work in her surgery.

Emma said she found the study days were pitched at a level for her to understand even though she was fairly new to dentistry. She was impressed with the tutors' knowledge on the latest legislation and advice. As her teachers were all working dental nurses they were also able to discuss contemporary real life situations with the students.

After the ART course, Emma said she felt more confident in the practice and more informed on health and safety issues. She was able to see how vital it was for a dental nurse to have a good understanding of both the theory and practice of dentistry.

There were one or two modules that Emma was not able to complete due to a booked holiday. However with the introduction of DNART she will be able to complete the course using the CD-ROM and have her certificates of competence ready for the GDC.

What next for her? Well with ART under her belt Emma has decided to undertake the NVQ in Oral Healthcare (Dental Nursing) at level three at Brighton College in September. She will attend the course for three hours one evening per week. Her work colleagues, including a dentist, hygienist, and dental nurse, have expressed their support and are keen to help her with any project work. An NVQ Assessor will attend the practice at regular intervals to observe Emma at work. The knowledge and understanding Emma received by completing ART will count for six of the currently mandatory nine units in the NVQ qualification.

For further information on any of the issues in this article please email Karen Silverthorne at kathrynm btconnect.com