Perspective of staff on student outreach placements
ABSTRACT To explore the perspectives of placement staff on outreach training.
Block clinical placements in primary care settings for dental undergraduates and hygiene and therapy students.
After completion of the placements, 32 participating staff across nine primary care locations took part in qualitative interviews and focus groups. The staff provided data on placement organisation, the students' development and their supervision, and any effects on themselves as hosts.
The major themes included the learning environment, supervision and communication. The staff saw benefits to students in working in a smaller primary care clinic with nursing support and immediately available supervision by a dental generalist. Other benefits included increased confidence, broader clinical experience and applying theoretical learning to new communities. Effective communication and adequate resourcing were critical success factors. There was some disruption of clinics' normal working, but many unanticipated benefits. Staff supported the outreach placements in primary care settings to enhance students' dental education.
These findings provide a planning and evaluation framework for dental educators involved in outreach.
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ABSTRACT: Access to dental care in the predominantly rural state of Tasmania remains challenged by the shortage of dental professionals. Without a dental school, Tasmania is dependent on dentists who have relocated from interstate or overseas. Within the public sector, which experiences intractable problems with recruitment and retention of dentists, dental visit patterns are characterised by a high proportion of episodic urgent care, lengthy waiting lists for comprehensive care and absence of recall. Coping with the level of demand for urgent care is a crucial element facing rural public dental services and the factors that underpin access to services and patient visit interactions are directly related to this level of demand. Recently, Tasmanian government-employed dentists argued that they were only 'fire-fighters' who attempt to manage patient load/time management in response to patient's general health, urgent dental needs and perceived levels of interest in oral health care. There were strong indications that expanding the capacity and the flexibility of the workforce would contribute to improved interactions with patients and improve access to a broader range of dental care within public sector clinical services. A unique agreement between the University of Tasmania and the Tasmanian Government in 2005 considered an innovative method to attract new dental graduates to Tasmania. In partnership with the University of Adelaide, the agreement set in motion an ongoing formal clinical attachment and scholarship scheme for dental students to undertake part of their final year of the Bachelor of Dental Surgery in the Tasmanian public sector. The objectives of this program included a concerted attempt to minimise the 'firefighter' perception of rural public dentistry. In this paper, the overarching problem of improving access to appropriate and affordable health care for rural communities is discussed in the context of government salaried dentists' perception of themselves as 'firefighters'. A strategy to address this perception, the clinical placements for final year dental students, is described and the results of a qualitative evaluation of the first cohort are analysed. The evaluation identified host benefits of the program including raising the profile of best practice and increasing staff sense of worth. In addition to high quality experiential learning opportunities, the placement program increased the capacity for autonomous clinical decisions, continuity of care and improved social interaction during dental visits as ways to minimise the perception of public sector dentists as 'fire-fighters'.
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ABSTRACT: Dental schools are developing new curricula, with outreach placements enhancing the hospital-based training. To assess the students' experience of outreach as one component of determining the value and feasibility of outreach placements. Six-week block placements for 10 undergraduates and 3 weeks for 11 hygiene and hygiene and therapy students in existing primary care clinics, in areas of need, to work supervised by local dentists. Semi-structured interviews with 20 students by staff independent of the course team. Interviews were audio-recorded, transcribed and content analysed before being verified by a second observer. Findings were triangulated against a peer-run focus group and students' clinical records. Students were very positive about their experience and the potential role of outreach training in dental education. They described: gaining greater experience of new types of patients and their communities; learning from broader clinical experience, alternative approaches and practicing or observing dentistry in different settings; the benefits of team working; and, acquiring a more holistic and pragmatic view of health care. Many students reported gaining greater confidence, wider awareness of potential careers in dentistry and a greater sense of realism in their experience. Some reflected on their own training needs. Students also discussed the importance of preparation for the placements and the merits of different styles of supervision. Dental outreach training can provide students with valuable learning experience in a range of areas. It requires careful management to ensure those experiences match individuals' needs and the programme's purposes.European Journal Of Dental Education 06/2006; 10(2):80-6. DOI:10.1111/j.1600-0579.2006.00396.x · 1.45 Impact Factor
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ABSTRACT: To examine the experience of being an outreach teacher of undergraduate restorative dentistry; to describe the desirable characteristics of such teachers; and to consider the management of outreach teaching. A three year pilot of an outreach course in fourth year restorative dentistry began in 2001. Students spent one day per week treating adults in NHS community dental clinics, run by Primary Care Trusts (PCTs). Action research involved monitoring meetings with students, clinic staff (dental teachers and nurses), and PCT clinical service managers. These data are supplemented by an independent evaluation involving interviews with dental school academic staff, and an account by an outreach teacher. Outreach is a different and more demanding context for teaching restorative dentistry than the dental hospital, characterised by isolation, management responsibility, pressure, a steep learning curve, and stress. The desirable characteristics of outreach teachers are those which enable them to cope in this environment, together with a student-centred teaching style, and the appropriate knowledge. Management of teaching passed to the PCTs and this created an additional workload for them in relation to staffing, risk, and service-based issues. Four teaching surgeries were the maximum for a satisfactory level of patient care and student supervision. A key issue for the dental school is quality. The changes to teaching and the teaching environment introduced during and after the pilot to address problems identified are described. In developing facilities to enable students to benefit from the advantages of outreach, dental schools should recognise that the characteristics of the outreach environment need to be taken into account during planning, that staff selection is a critical success factor, and that an ongoing proactive approach to organisational arrangements and to the support of teaching staff is necessary.British dental journal official journal of the British Dental Association: BDJ online 09/2007; 203(3):127-32. DOI:10.1038/bdj.2007.681 · 1.08 Impact Factor