Introduction

Abstract

The DentCPD Project aimed to promote harmonisation and standardisation of continuing professional development (CPD) for graduate dentists in Europe. The Project was designed to identify and agree ‘essential’ CPD requirements for all EU graduate dentists and to provide guidelines for the management and delivery of high-quality CPD by European dental schools in higher education institutions (HEIs). In turn, it was hoped that this would stimulate greater cooperation between all those who are involved in the delivery of CPD to graduate dentists. This Project was initiated through the Association for Dental Education in Europe (ADEE). ADEE has contributed extensively to the harmonisation of dental education, at the undergraduate level, in Europe, through its EU funded DentEd programmes. The DentCPD Project is the first of its kind in Dentistry, building on the 2009 EU theme of ‘Creativity and Innovation’. There have been several studies analysing doctors' performance and healthcare outcomes following CPD, but few previous attempts to investigate CPD provision for dentists in different countries. Focused on continuing education and the strategic role of dental schools, this Project built on the success of ADEE's DentEd programme which produced three key strategic documents for undergraduate education 1-3. CPD is essential to the maintenance of a dentist's knowledge, understanding and skills, underpinning safe clinical practice. However, there is no harmonisation or standardisation of the ‘essential’ CPD requirements of graduate dentists or agreement on the appropriate regulation of CPD delivery for graduate dentists in the EU. CPD available to graduate dentists across the EU is hugely variable and provided by a range of bodies including dental schools in HEIs but also other stakeholders including the public sector and industry, not all of which are subject to quality management. Some EU countries have schemes that mandate dentists to engage in a minimum number of hours of CPD in a given period. Other countries prescribe essential CPD topics like cross-infection control, medical emergencies and other topics relating to patient safety. Currently, across Europe, CPD provision is largely unregulated. However, there is a widespread movement towards systems of recertification or relicensure for healthcare providers. These are likely to be based on appraisal processes and CPD achievements which will be mandatory for dentists to remain on a dental register. Thus, CPD will, increasingly, be seen as an essential aspect of a dental professional's working life. Therefore, to promote the mobility of dental practitioners and to support the equity of education provision and safe management of patients, there is a need for standardisation and harmonisation of CPD content across the EU. This Project reviewed and ascertained the essential knowledge and skills that all EU dentists should be expected to maintain. It also identified evidence of best practice in CPD delivery and quality management of that provision. As EU dental schools play a strategic role in CPD delivery, this Project supports the modernisation of their role in postgraduate education. Europe-wide recognition of dental CPD supports both the introduction of recertification and the freedom of movement of dental practitioners. In supporting the role of dental schools, this Project assists in the modernisation of higher education, one of the ‘learning clusters’ highlighted in the ‘Education and Training 2010 Work Programme’, promoting the three common objectives of the programme which include: quality, access and openness. The efforts of this Project to harmonise dental CPD across the EU, places high on the agenda the European Quality Framework (EQF), the National Quality Framework and thus the Framework for Qualifications of the Higher Education Area 4, 5. In so doing, the Project aimed to make qualifications and CPD activity from different countries easier to compare, supporting wider recognition and in turn promoting the mobility of graduate dentists between different institutions and across different working environments. In promoting the convergence, transparency and portability of CPD for graduate dentists working in the EU, this Project should better enable mobility of practitioners anywhere within the EU and beyond. To achieve the Project aims to identify agreed essential CPD requirements of an EU graduate dentist and to provide guidelines for the management and delivery of high-quality CPD by European dental schools, the following objectives were agreed: In turn, achievement of these objectives should support: Dissemination of materials and areas of best practice, produced and identified through this Project, should contribute to the modernisation of HEIs, enhance the efficiency of CPD provision by a variety of educational stakeholders and lead to exploitation of the outcomes throughout the EU and beyond. The initial target groups, for the Project, were the CPD programme managers of the dental schools in the five partner countries. They benefited directly during the lifetime of the Project from the guidelines and the freely available exemplar module with guidelines on using modern technology and pedagogy in delivering CPD. Beyond this initial target group and throughout the duration of the Project, programme managers of other countries were included through participation in the special interest working groups (SIG) on harmonisation of dental CPD and Lifelong Learning, during the ADEE meetings held in 2011 and 2012. The principal target groups are the learners and the teachers, that is, the graduate dentists and the dental CPD educators. They should profit from robust and structured CPD programmes across Europe which in turn should facilitate the movement of dental practitioners across Europe. Ultimately, the hope is that the European patient profits from better and more equitable clinical care and improved patient safety across the EU, supported by high-quality CPD opportunities for those in the dental profession. In the context of freedom of movement, EU citizens need assurance that dental practitioners, providing their care, have a degree/licence to practice that meets EU standards and that they maintain their knowledge and skills via ongoing education, underpinning their clinical expertise. CPD acquisition is the principal mechanism which supports this process. This Project was undertaken by the pan-European Project team in cooperation with a variety of educational stakeholders. Five schools, regionally spread across Europe, based in Cardiff, Amsterdam, Helsinki, Riga and Athens, together with ADEE formed the Project Team in which Cardiff University took the lead and the role of Project coordination. Wider stakeholder contribution included a consortium of experts, the SIGs, professional association representatives, university representatives and other stakeholders linked through the extensive networks of the ADEE, which has 185 institutional members geographically widely dispersed across Europe. In addition to the 29 dental schools based in the countries of the six consortium partners, some of these also acted as test sites for the identification of core dental CPD topics and determining the value of the Guidelines for the organisation of dental CPD. A significant body of information was collected, reviewed, and the Project outputs were agreed and finalised over several face-to-face meetings, tele- and video conferences and frequent (often daily) email contacts between members of the Project team. During the life of the Project, two meetings of the ADEE SIG were held, in 2011 and 2012. The Project Team made presentations at a variety of other educational conferences across the EU and beyond, including in South America, at the International Association for Dental Research (IADR) in San Diego (2011), IADR at Iguassu Falls, Brazil 2012, the Pan-European meeting in Helsinki 2012 and in China in 2012. A dedicated Project website - www.DentCPD.org - was established. This provides access to many of the Project outputs, including: Project reports, publications, guidelines and educational materials. The DentEd network was and continues to be used for the execution, dissemination and exploitation of the findings. DentCPD has successfully fulfilled its ambitions and objectives in respect of its efforts to support harmonisation of CPD across the EU. Essential skills and knowledge that all EU dentists should be expected to maintain have been agreed; evidence of best practise in CPD delivery has been identified; and clear EU recognised guidelines on organisation and quality management of CPD programmes have been developed. In recent times, ADEE, also being one of the partners of the DentCPD Project, has successfully developed and implemented the DentEd programmes. These produced three key strategic documents for undergraduate education covering the areas of: Profiles & Competences of the Graduate Dentist 1; Curriculum Development & Mobility 2; and Quality Assurance 3. These have been accepted by the vast majority of European dental schools. Harmonisation of CPD after graduation represents a natural progression for the work of ADEE and its membership. Harmonisation of the continuing education of qualified dentists helps to create a seamless transition from undergraduate training into a period of lifelong learning. This supports European Unification, the freedom of movement of dental healthcare professional throughout Europe as well as promoting the safety of the patients. This supplement to the European Journal of Dental Education brings together, in the form of a CPD Reference Manual, the products and outcomes of the DentCPD Project which it is hoped will facilitate and support all those involved in CPD delivery and learning in the context of lifelong learning for the dental profession. One of the DentCPD Project's aims was to develop an inventory of existing CPD programmes and providers and agreement on core components of CPD. This was achieved through an internet and literature search and survey. The survey was conducted using a questionnaire devised by the DentCPD Project Team and circulated to European Dental Schools, Professional Associations and other dental educational stakeholders [see Appendix 1 12]. A second questionnaire was developed and distributed to dental practitioners in four EU countries. Agreement on core components of CPD was achieved following a consensus process at the annual meeting of the ADEE in 2011, informed by the survey results. The results are described elsewhere in this supplement 6-8 The inventory provides a record of existing CPD requirements, activities and providers. It included information on accreditation and assessment systems, factors affecting CPD uptake, methods of CPD delivery and the effectiveness of CPD in dentistry and impact on practice. Additional information relating to the survey of dental CPD provision is presented in appendices 1–3 12. Appendix 2 provides additional details reported by different EU countries, from the surveys in relation to: whether dental CPD is compulsory or not; CPD requirements; identified core dental CPD topics; CPD providers and who pays; and issues around accreditation of CPD provision. Some of the respondents provided a brief summary of the criteria that they believed are used to facilitate accreditation of CPD activities. This is displayed in appendix 3; however, as stated in the survey report 7, there clearly remains a great detail of confusion and lack of understanding around the quality assurance and accreditation/recognition of dental graduate CPD. This inventory includes the three following publications entitled: These, in turn, contributed to the compilation of the Guidelines and e-module developments described later in this supplement 9-11. In addition, readers are referred to the CPD toolkits accessible on the DentCPD website, and these are presented in appendices 4a–4d 12. The authors confirm that they have no conflicts of interest to declare.