UK Dental Schools Research Articles

Do high tuition fees make a difference in dentistry?

Do high tuition fees make a difference? Characteristics of applicants to UK medical and dental schools before and after the introduction of high tuition fees in 2012.

Do high tuition fees make a difference? Characteristics of applicants to UK medical and dental schools before and after the introduction of high tuition fees in 2012.

Aim To compare trends in the volume, socio-demography and academic experience of UK applicants and entrants to medicine and dentistry in the UK with university in general, before and after the major increase in university fees in England in 2012.Methods Descriptive trend analyses of University and College Admissions Services (UCAS) data for focused (preferred subject was medicine or dentistry) and accepted applicants, 2010-14, compared with university in general in relation to socio-demography (age, sex, ethnicity, POLAR 2, region) and academic experience (school type). POLAR2 data provide an indication of the likelihood of young people in the area participating in further or higher education.Results In 2012 the volume of applicants to medicine and dentistry fell by 2.4% and 7.8% respectively, compared with 6.6% for university overall. Medical applications remained buoyant and by 2014 had risen by 10.2% from 2010 to 23,365. While dental applications fell in both 2012 and 2013, they had increased by 15.6% to 3,410 in 2014, above 2010 levels. Females formed the majority of applicants, and admissions, with the proportion gaining admission to dentistry in 2014 reaching an all-time high (64%), exceeding medicine (56%), and university in general (56%). Mature admissions to dentistry were at their highest in 2010 (29%) falling to 21% in 2014, compared with 22-24% in medicine. Black and minority ethnic group admissions to university, although rising (24% in 2014), are still less than for medicine (34%) and dentistry (48%). In 2013, just over half of the students admitted to dentistry were from BME groups (51%) for dentistry. Among UK applicants <19 years, over 60% of applicants, and 70% of accepted applicants, to medicine and dentistry are from the top two POLAR2 quintiles representing areas of high participation in education; however, in 2014 there was a notable increase in the proportion of applications from the lower two quintiles to dentistry (19%) and medicine (20%), with a very modest increase in those gaining admission over 2012 (14% of both; cf 10% and 12% respectively).Discussion The findings suggest that the short-term impact of the 2012 rise in fees had a greater influence on the volume and nature of applicants to dentistry than medicine, and that both programmes are gaining in popularity, despite high fees and reduced places. Dentistry remains particularly attractive to Asians, and females, the latter forming an increasing majority of students. While there is some recovery, social inequalities exist and present a challenge for widening participation in the professions.

The Association between Postgraduate Studies, Gender and Qualifying Dental School for Graduates Qualifying from UK Dental Schools between 2000 and 2009.

Various factors will influence a dental graduate’s decision to undertake postgraduate education and training, including encouragement from family, partners and staff at individual dental schools, although there is currently little information available regarding the number and distribution (by dental school) of recent dental graduates undertaking postgraduate studies. The aim of this study was to analyse data on postgraduate qualifications achieved by dentists who graduated from UK dental schools between 2000 and 2009 and relate this to graduate gender. Data were collected from the General Dental Council (GDC) in an anonymous electronic format, analysed and ordered by year of graduation, dental school, gender and type of postgraduate qualification. Nearly one-quarter (24%) of the dentists that graduated between 2000 and 2004 completed postgraduate studies, with more females (26%) than males (23%) obtaining further postgraduate qualifications. Overall, Bristol produced the largest proportion of graduates completing postgraduate study (39%) and of these the largest proportion of female graduates (45%). Glasgow produced the largest proportion of male graduates completing postgraduate study (37%). Membership of the Faculty of Dental Surgery (MFDS), one of the Royal Colleges, was the most popular postgraduate qualification obtained followed by Membership of the Faculty of General Dental Practitioners UK (MFGDP). This study provides insight into postgraduate studies undertaken by UK dental graduates. An increasing proportion of females are gaining Bachelor of Dental Surgery (BDS) qualifications and therefore the number of female dental graduates obtaining postgraduate qualifications is likely to increase further. This also suggests the male domination of the dental profession is likely to decrease.

Student perceptions of exodontia competency assessment in a UK dental school.

Modern medical and dental training has migrated from assessing only the quantity of procedures performed to a combined assessment of both competency and quantity. This study explores student perceptions of competency assessment in exodontia at a UK dental school. Anonymous questionnaires were distributed to dental students in years three, four and five at the School of Dentistry, Cardiff University (n=149). Responses consisted of dichotomous tick boxes and 5-point Likert scales, with thematic analysis of free-text responses. Discrete variables were analysed using simple descriptive statistics. Recurring themes were identified from the responses. A total of 129 questionnaires were returned (response rate 87%). Feedback from students indicated that they felt well prepared to undertake the competency assessment, agreeing that year three is the most appropriate year to assess competency (69%; n=86). In 50% of cases (n=65), the clinical supervisor was not present for the duration of the assessment. The undergraduate student body would like further teaching in the use of elevators (89%; n=114). The competency assessment was deemed fit for purpose by the undergraduate student body. Further developments in the areas of clinical supervision and teaching on the use of elevators were considered and recommendations made to the School of Dentistry, Cardiff University. The current oral surgery course incorporates some of the recommendations.

Exploring uses of the UK Clinical Aptitude Test-situational judgement test in a dental student selection process.

In 2013 the UKCAT included a non-cognitive situational judgement test in addition to the four cognitive subtests commonly used by UK dental schools to select students. However, little is known about the situational judgement test's psychometric properties and relationship to other selection tools. This study's aim was explore these issues to inform decisions about the inclusion of the UKCAT SJT in the dental student selection process. The sample comprised a cohort of applicants to a Bachelor of Dental Surgery programme, at a UK dental school, which does not use achievement in the UKCAT SJT in its selection process. The impact on applicant outcomes of two theoretical uses of the UKCAT SJT was examined. First, SJT Band was used as the criterion for offers of a place instead of the school's admission interview, and second, weighted UKCAT scores, including a weighted SJT Band score, were ranked to make interview invitation decisions. Associations between SJT Band, UKCAT cognitive scores, interview score and performance in first year assessments were examined. If SJT Band 1 & 2 were used as the criterion for an offer of a place, some applicants rejected by this school's interview, including 'red flagged' applicants, would have received an offer of a place. Using a weighted UKCAT/SJT system for invitation for interview decisions increased the mean total UKCAT cognitive score of those invited for interview but included applicants rejected by this school's structured interview, including 'red flagged' applicants. Neither usage disadvantaged under-represented groups. SJT Band correlated with UKCAT score (n = 228, rs = -0.38, P < 0.01) with interview score (n = 186, rs = -0.17, P < 0.05) but not with first year study assessments. This study has shown that the UKCAT SJT does not add value to the existing methods of this dental school to make valid, reliable and fair student selection decisions.

Musculoskeletal neck and back pain in undergraduate dental students at a UK dental school - a cross-sectional study.

Objective Limited data exist on musculoskeletal problems within dental students: we aimed to determine the prevalence of these disorders.Design Single centre cross-sectional study.Setting A UK Dental School 2015.Methods Students completed a modified Nordic pain questionnaire.Main outcome measures Self-reported frequency and severity of pain, fitness and coping strategies.Results 63% of 390 respondents were female and 75% aged under 23. Seventy-nine percent experienced pain with 42% experiencing pain for 30 or more days in the past year. Lower back pain was most common (54%) and was most frequently the worst area of pain (48%). Thirty-six percent reported pain lasting at least four hours. The mean 'average pain intensity' VAS score was 3.81/10 (sd = 1.75) and mean 'worst pain intensity' was 5.56 (sd = 2.10). More females reported neck pain (58% versus 37%, P <0.001) and higher 'average pain intensity' (mean 4.02, sd 1.82 versus 3.43 sd 1.55, P = 0.012. Daily stretching was used by 55.7% of respondents, and this positively correlated with 'average' and 'worst pain intensity' (P = 0.096 and P = 0.001) scores. Eighteen percent sought professional help to manage pain.Conclusion Musculoskeletal pain is a problem for dental students. Education in self-care may be helpful; however, assessments of possible interventions are needed.

Final-Year Dental Undergraduate Attitudes towards Specialisation.

The aim of this study was to explore the attitudes towards postgraduate specialisation of final-year students at one UK dental school and to identify any possible influencing factors. A cross-sectional survey of all 73 final-year students using an anonymous self-report questionnaire was carried out. The response rate was 79%, of which nearly two-thirds were female. Age, ethnicity and parental occupation did not have an effect on the intention to specialise, although student gender did, with more females not wishing to specialise (p = 0.006). Having a ‘talent in the field’ had the largest positive influence on pursuing a specialist career (37.9% of responses), whilst the length of time needed to obtain a specialist qualification was seen as the largest negative influence (41.1% of responses). The two most popular subjects were Restorative Dentistry and Orthodontics with 24.1% and 20.7% of students listing them as their first choices, respectively. Further research could be carried out to determine if the intentions of UK undergraduates to specialise will meet the increasing specialist oral health needs of the population and which could ultimately influence future dental workforce planning.

Peer review of teaching in UK dental schools. Is it happening? How successful is it?

Aim The aim of this study was to investigate the utilisation of peer review of teaching (PRT) within UK dental schools.Method A structured questionnaire was emailed to all sixteen UK dental schools seeking information on existing PRT schemes, level of staff engagement, and the success of schemes in relation to extent of operation and perceived benefit.Results A 100% response rate was achieved. Fourteen schools (88%) operate PRT schemes. For most, the expected frequency of staff engagement is annually, although there was a wide range between schools (minimum = once every five years, maximum = three times per year). Nine schools (64%) consider their schemes to be fully operational. Twelve schools (86%) feel their staff are either mostly or fully engaged. Reasons for sub-optimal operation and/or engagement include: newly introduced schemes, problems with compliance for off-campus staff, and loss of momentum. Thirteen schools (93%) consider that PRT benefits their teaching staff. Ten schools (71%) stated that changes are required to their schemes.Conclusion PRT is operating within the majority of U.K dental schools but the format and success of schemes varies. Schemes will benefit from ongoing development but changes should take into account evidence from the literature, particularly recognised models of PRT.

Attitudes towards Prosthodontic Clinical Decision-Making for Edentulous Patients among South West Deanery Dental Foundation Year One Dentists.

The aim of this study was to describe Dental Foundation year one dentists’ attitudes towards prosthodontic decision making for edentulous patients, and identify whether there are gender differences in these attitudes. All South West Deanery trainees were invited to take part in the study between May and June 2011 and a previously piloted questionnaire was administered to the trainees by their training programme directors. The questionnaire posed questions based upon a clinical scenario of discussing treatment options with patients. Seventy-two questionnaires were used in the analysis (91% overall response rate). Trainees perceived their own values to be less important than the patient’s values (p < 0.001) in decision making, but similar to the patient’s friend’s/relative’s values (p = 0.1). In addition, the trainees perceived the patient’s values to be less important than their friend’s/relatives (p < 0.001). Sixty-six per cent of trainees acknowledged an influence from their own personal values on their presentation of material to patients who are in the process of choosing among different treatment options, and 87% thought their edentulous patients were satisfied with the decision making process when choosing among different treatment options. Fifty-eight per cent of trainees supported a strategy of negotiation between patients and clinicians (shared decision making). There was no strong evidence to suggest gender had an influence on the attitudes towards decision making. The finding of a consensus towards shared decision making in the attitudes of trainees, and no gender differences is encouraging and is supportive of UK dental schools’ ability to foster ethical and professional values among dentists.

Does a selection interview predict year 1 performance in dental school?

This study was undertaken in order to determine whether different interview methods (Cardiff with a multiple mini interview and Newcastle with a more traditional interview process) along with other components used in selection predicted academic performance in students. The admissions selection data for two dental schools (Cardiff and Newcastle) were collected and analysed alongside student performance in academic examinations in Year 1 of the respective schools. Correlation statistics were used to determine whether selection tools had any relevance to academic performance once students were admitted to their respective Universities. Data was available for a total of 177 students (77 Cardiff and 100 Newcastle). Examination performance did not correlate with admission interview scores at either school; however UKCAT score was linked to poor academic performance. Although interview methodology does not appear to correlate with academic performance it remains an integral and very necessary part of the admissions process. Ultimately schools need to be comfortable with their admissions procedures in attracting and selecting the calibre of students they desire.

Periodontology in the undergraduate curriculum in UK dental schools.

In 1980 the British Society of Periodontology published a series of educational goals which have guided periodontal curricula at UK dental schools. Further, a survey of UK dental schools evaluated aspects of teaching and learning in periodontology. The aims of this project were to identify teaching practices and assessments in periodontology and best practice which may be developed in the future. A questionnaire was sent to dental schools who had participated in the previous survey. The questionnaire sought information on aspects of teaching and learning in periodontology: teaching manpower, curriculum structure, assessment, research opportunities for students and whether implantology is delivered in the undergraduate curriculum. There is consistency between the education providers with respect to teaching and learning in periodontology. Most are developing integrated learning between dental undergraduates and members of the dental team although there are opportunities for further development. Students are expected to have knowledge of complex treatments but are not expected to be competent at undertaking periodontal surgery nor placing and restoring implants. The findings confirm that there is considerable consistency between the education providers with respect to aspects of teaching and learning in periodontology.

Undergraduates' perceptions of the value of practical inhalation sedation experience in a UK dental school.

This was to establish the level and reported value of paediatric IHS experience from the perspective of final year undergraduates and to evaluate whether those students with more experience expressed feeling better-prepared for future practice and more likely to undertake further postgraduate education in IHS. All final year students were invited to complete an anonymous questionnaire designed to elicit undergraduate perceptions of IHS using visual analogue scales and free-text questions. A response rate of 77 % was achieved. Results revealed that only 21 % of participants reported acting as operator sedationist in ten or more IHS cases. Thus, the majority of undergraduates' did not meet the recommended quantity of practical IHS experiences, as outlined by the British Dental Sedation Teachers Group. In general, students felt on the value of IHS in the management of anxious children and expressed a desire to undertake further postgraduate education in conscious sedation. However, those students with more experience of practical IHS expressed feeling better able to describe the IHS experience with patients and parents, and were more satisfied with the quality of teaching. Furthermore free-text comments revealed that, regardless of experience, students wished to gain more experience of the practical administration of IHS. There is a need to increase the provision of IHS training within an undergraduate curriculum, in addition to improving the accessibility of postgraduate sedation courses.

The views of part-time clinical teachers regarding their role in undergraduate education at the University of Bristol Dental School.

UK dental schools are reliant on part-time teachers to deliver the clinical educational component of the course, the majority with a background in general dental practice. Opportunities for promotion are limited, as is the support for obtaining educational qualifications. The aim of this study was to ascertain the views of such teachers at a dental school. An anonymous online survey was used to obtain both qualitative and quantitative views. The response rate was 80%. The school has n = 50 part-time clinical teachers, who have been teaching for, on average ten years, and for three sessions per week. Eighteen percent of teachers are recognised specialists. Forty-six percent of respondents have a formal teaching qualification, mostly at certificate level, and 55% thought it necessary to acquire a formal teaching qualification. Eighty-eight percent were happy with their role as clinical teachers. This study demonstrates that despite the lack of support and prospect of career progression, the majority of part-time clinical teachers at this institution are satisfied with their role.

The introduction of digital dental technology into BDS curricula.

The aim of this study was to determine the degree to which digital dental technologies have been introduced into the curricula of UK dental schools. A survey was carried out of all the UK dental schools that teach undergraduate dental students. The survey contained six questions and was designed to determine if digital dental technology techniques or systems were being taught in the curricula, what these techniques were, and whether the school dental laboratories supported these techniques. Sixteen schools were surveyed and 11 replied: a response rate of 69%. Forty-five percent of the schools that replied did not teach digital dental technology in their curriculum. Of the 55% of schools who did teach digital dental technology, 50% gave lectures or demonstrations while the other 50% allowed practical involvement by the student. Two thirds of these stated that not all the students participated in practical usage. Seventy-three percent of the schools that replied had dental laboratories using some, but not all the digital dental technology techniques listed. Eighty percent of the schools that were not teaching digital dental technology said it was because it was not included in the curriculum, and 20% stated it was due to a lack of technical expertise or support.

Developmental guidelines for good chairside teaching – a consensus report from two conferences.

Developmental Guidelines for Chairside Teaching are a direct outcome of 10 years of research, originally prompted by feedback from undergraduate dental students who not only thought that the teaching they received was uneven and variable in quality, but also felt strongly that they learned more with educationally trained teachers than those with little or no teacher training. Workshops embracing the views of teaching colleagues from many other Dental Schools produced a consensus view that developmental guidelines for teachers would provide a valuable resource. A conference to consider all aspects on chairside teaching and learning was convened with delegates invited from all UK Dental Schools. This was subsequently followed by a second conference to develop specific guidelines for chairside teaching and learning. The Nominal Group Technique was used in the first chairside teaching conference, and Structured Small Expert Groups were used in the second. The overall consensus from these workshops and conferences were as follows: (i) developmental guidelines for chairside teaching can act as a useful resource for teachers to improve and maintain their standard of chairside teaching, (ii) developmental guidelines can be divided into themes of organisational issues and learner and teacher qualities, and (iii) Guidelines should be 'developmental' because they encourage chairside teachers to focus on the next immediate goal to maintain and improve quality and standards. These developmental guidelines could provide a universal toolkit for improved chairside teaching which would result in a better student learning experience. Set out in this way these guidelines have currency across academic and practical skills levels, different educational systems, philosophies and country boundaries.

Patient-centred care: barriers and opportunities in the dental surgery.

This paper explores the practice of patient-centred care (PCC) within dentistry. The aim of this research was to explore the barriers and opportunities dentists face in practicing PCC. The results of N=20 thematically analysed, in-depth semi-structured qualitative interviews with a range of dentists working across clinical and teaching positions within a large UK dental school are presented. PCC was generally considered a positive, to be embraced concept which dentists believe they practice daily in the absence of any formal training. PCC presented dentists with opportunities to deliver treatment to highly compliant patients. The main barriers revolved around patients (e.g. disengaged or overly inquisitive) and practice factors (e.g. time and funding). PCC is a concept that is generally seen as important in the dental surgery, presenting dentists with opportunities for compliance-enhanced practice. Significant work is needed if dentists are going to be supported in overcoming self-identified barriers to their delivery of PCC as per UK General Dental Council guidelines.

Iain Chapple: 'As a clinician, you assume that people know what periodontitis is'

Iain Chapple talks to the BDJ about implant failure, the teaching predicament for UK dental schools and why we must teach the public about the dangers of periodontitis.

Validity of the UKCAT in Applicant Selection and Predicting Exam Performance in UK Dental Students

The United Kingdom's Clinical Aptitude Test (UKCAT) aims to assess candidates' "natural talent" for dentistry. The aim of this study was to determine the validity of the UKCAT for dental school applicant selection. The relationship of the UKCAT with demographic and academic variables was examined, assessing if the likelihood of being offered a place at a UK dental school was predicted by demographic factors and academic selection tools (predicted grades and existing school results). Finally, the validity of these selection tools in predicting first-year dental exam performance was assessed. Correlational and regression analyses showed that females and poorer students were more likely to have lower UKCAT scores. Gender and social class did not, however, predict first-year dental exam performance. UKCAT scores predicted the likelihood of the candidate being offered a place in the dental course; however, they did not predict exam performance during the first year of the course. Indeed, the only predictor of dental exam performance was existing school results. These findings argue against the use of the UKCAT as the sole determinant in dental applicant selection, instead highlighting the value of using existing school results.

An investigation of complete denture teaching in the UK: part 1. A survey of undergraduate teaching

This paper is the first in a series of two that investigate the undergraduate teaching of complete dentures in the UK. A questionnaire was sent by email to 13 UK dental schools enquiring about the number of hours spent in the lecture theatre, laboratory and clinic. The schools were also asked to give their views about the preparedness of the new graduates for dealing with complete dentures in general practice. There was great disparity between schools in the overall number of lectures delivered. Two schools claimed 28 hours and the remainder varied between 6-15 hours. Four schools devoted more time to laboratory work whereas three schools spent more time in the clinic. One school reported no dedicated clinical time for complete dentures. There appears to be a regional variation with northern UK dental schools spending more time on the teaching of complete dentures. The quota for complete dentures varied from three in most schools to eight in one school and none in another. Comments from the dental schools varied from a reported lack of suitable complete denture cases, to concerns with insufficient curricular time devoted to the subject and a subsequent lack of clinical competence on graduation. Some schools have integrated complete denture teaching into the general prosthodontic course as it is considered inappropriate to teach different aspects of prosthetics in isolation. Competence in complete dentures falls short of what is expected. With a single exception all the schools seem to have low expectations for their undergraduate students to be practically trained and experienced in the production of complete dentures. Despite the advent of implants and the introduction of clinical dental technicians, there is and will continue to be a need for the competent treatment of the edentulous population by general practitioners.

Is embellishing UCAS personal statements accepted practice in applications to medicine and dentistry?

Background: The assessment of non-academic achievements through the personal statement remains part of the selection process at most UK medical and dental schools. Such statement offers applicants an opportunity to highlight their non-academic achievements, but the highly competitive nature of the process may tempt them to exaggerate their accomplishments. The challenge is that selectors cannot discern applicants’ exaggerated claims from genuine accounts and the system risks preferentially selecting dishonest applicants.Aim: To explore the level and perception of deception on UCAS personal statements among applicants to medical and dental schools. To investigate the association between attitudes towards deception and various other demographic variables and cognitive ability via the UKCAT.Methods: An online survey was completed with first year students from six UK medical schools and one dental school. Questionnaire items were classified into three categories involving individual acts, how they suspect their peers behave, and overall perceptions of personal statements to influence the selection process. Descriptive statistics were used to investigate responses to questionnaire items. t-Tests were used to investigate the relationship between items, demographic variables and cognitive ability.Results: Candidates recognized that putting fraudulent information or exaggerating one's experience on UCAS personal statement was dishonest; however there is a widespread belief that their peers do it. Female respondents and those with a higher UKCAT score were more likely to condemn deceptive practices.Conclusion: The existing selection process is open to abuse and may benefit dishonest applicants. Admission systems should consider investing in systems that can pursue traceable information that applicants provide, and nullify the application should it contain fraudulent information.