Meeting the oral health care needs of patients with disabilities. Is the new dental graduate prepared?

kathy wilsonIntroduction

Dr Kathy Wilson, based at Newcastle Dental Hospital and School, is an Associate Specialist in Dental Sedation and Specialist in Special Care Dentistry. She is currently undertaking the Masters in Medical Education programme and developing a study entitled “Meeting the oral health care needs of patients with disabilities – Is the new dental graduate prepared?”

 

Back Ground to study

Special Care Dentistry (SCD) is defined as “The improvement of oral health of individuals and groups in society, who have a physical, sensory, intellectual, mental, medical, emotional, or social impairment or disability, or more often, a combination of a number of these factors”

In 2008 SCD was recognised by the General Dental Council (GDC) as a speciality and the GDC document “Preparing for Practice” states “The Registrant will recognise and take account of the needs of different patient groups including children, adults, older people and those with special care requirements through-out the patient care process

Newcastle Dental School’s SCD programme has the aim “To enable students to provide general oral care for those patients with special needs”. The virtual programme is delivered mainly through other specialties, with some specific lectures; in speaking to final year dental students it would appear that many have deficiencies in their knowledge and understanding of the needs of patients with disabilities.

A review of the literature indicates that General Dental Practitioners cite lack of experience and undergraduate education as reasons for being less confident in meeting the needs of vulnerable patients, so creating barriers to effective delivery of oral care. Reducing social factors contributing to health inequalities requires action beyond service provision; it is estimated that 90% of people requiring SCD should be able to access care through the general dental service in primary care which necessitates appropriate education of dental professionals.

By considering views of Newcastle dental students it is anticipated the SCD programme can be tailored to develop professionals who view this specialty positively and are confident in recognising the needs of those who are vulnerable within our society, therefore full-filling their professional obligations.

 

Aim of Study

To explore final year dental students’ preparedness to address the oral health care needs of patients with disabilities in order to inform the Special Care Dentistry programme review.

 

Study Design

The study will be carried out as a series of focus groups to address the research questions. It is hoped that the field work will be carried out in the autumn of 2016 and that the results will help to inform development of the teaching of Special Care Dentistry to undergraduate dental students.

Dr Kathy Wilson, School of Dental Sciences

Innovative artistic learning methods in anatomy education

Iain Keenan - Medical EducationMy research aims to provide quality, variety and engagement in anatomy education at minimal cost through development and evaluation of artistic and other innovative learning methods. Outputs have been achieved through collaborations with professional visual artist Rachael Allen and undergraduate project student partners and have contributed to my Teaching Excellence Award in 2015 for innovation (FMS).

Initially, we designed our novel cyclical artistic learning process Observe-reflect-draw-edit-repeat (ORDER) to provide a theoretical and practical framework for the use of artistic methods in anatomy, work that has been presented at Anatomical Society conferences [1, 2] and elsewhere. A manuscript outlining our design and experimental evaluation of ORDER has recently been submitted to an anatomy education journal for publication [3].

Our current focus concerns reciprocal transitions in understanding between 3D anatomical structures and 2D clinical images as a threshold concept. Ongoing work will demonstrate how we have developed ORDER to facilitate these transitions through 3D anatomical modelling and 2D cross-sectional drawing in practical sessions and with supplementary interactive online video tutorials [4]. Our future work will explore social media tools in learning and teaching and innovative embryology resources.

Our 2014 NICAP (Newcastle University Institute of Creative Arts Practice) Award has funded Artatomy, an exhibition of anatomical artwork created by FMS students that began with optional dissecting room drawing sessions. Artatomy opened at the Venue, Students Union in April and ran for a durational show at the Centre for Life during summer 2015. Artatomy has been covered by Times Higher Education [5] and Research Fortnight [6].

Dr Iain Keenan, School of Medical Education

  1. Backhouse, M., et al. ORDER (observe-reflect-draw-edit-repeat): a novel cyclical learning process in anatomy education. in Anatomical Society Summer Meeting 2014 Skin and Bones. 2014. University of Bradford: Journal of Anatomy.
  2. Keenan, I.D., et al. The future ORDER: a student partner approach for evidence-based evaluation and implementation of an ‘observe–reflect–draw–edit–repeat’ artistic learning process in anatomy education. in Anatomical Society Winter 2013: Assessment and Sense Organs. 2013. Newcastle University: Journal of Anatomy.
  3. Backhouse, M., et al., ORDER (observe-reflect-draw-edit-repeat): Design and evaluation of a novel cyclical artistic learning process for anatomy education. 2015, in preparation.
  4. Hutchinson, J. and I.D. Keenan, Design and evaluation of online interactive video tutorials for the use of ORDER (observe-reflect-draw-edit-repeat) as an adjunct to anatomy learning. 2015, in preparation.
  5. Campus News – Newcastle University. 2015 26.08.15]; Available from: https://www.timeshighereducation.co.uk/content/minority-students-benefit-from-confidence-building-measures.
  6. Brooks, J. Newcastle builds bridges between art and science. 2015 26.08.15]; Available from: http://www.researchresearch.com/index.php?option=com_news&template=rr_2col&view=article&articleId=1352358.

Student Perceptions of Barriers to a Career in Science

The School of Biomedical Sciences (SBMS) has developed numerous initiatives to help students determine their graduate career path. These include; Employability Ambassadors, the Lab Assistants scheme, the SOLAR group and promoting becoming STEM Ambassadors. We have a Careers Liaison Academic within the School providing advice and coaching for students to gain experience and apply for roles such as Industrial Placement Years.

SBMS has a 57% female cohort (2013-14) which is slightly lower than the STEMM (science, technology, engineering, maths and medicine) average for the Russell group (61%) but higher than that for STEMM at Newcastle University (42%). Nationally there is a trend of fewer females at higher grades of scientific academia (notably from second post-doctoral position to professorial grade). The ECU Athena SWAN charter is committed to advancing gender equality in academia, particularly addressing the loss of women across the STEMM career pipeline. The School of Biomedical Sciences has recently submitted an Athena SWAN silver award application.

Preliminary research conducted in conjunction with Northumbria University, showing that a large majority of all stage 1 bioscience students, when asked to draw their ‘Perception of a biomedical scientist’, drew male scientist stereotypes. Interestingly, students from a widening participation background (regardless of gender) drew a more gender balanced proportion of scientists, suggesting they were less conditioned to what a biomedical scientist ‘should’ look like. This research will be repeated annually with stage 1 students and with the same cohorts in their final year to determine if there is a shift in gender perception.

As part of the school self-assessment process, we commissioned a ‘Women in Science’ panel and networking event to specifically promote scientific careers to female undergraduates (http://www.ncl.ac.uk/biomed/about/athenaswan/News.htm). Feedback collected from attendees (>100) reassuringly showed that the event helped their scientific careers awareness, with many positive comments regarding support provided by the school. Given that the majority of the attendees were actually stage 1 students, we were very surprised that so many expressed concern about barriers to their scientific career prospects. Some issues which arose included; perceiving having a family as detrimental to career progression, lack of exposure to female role models, and feeling a lack of confidence in approaching academic staff.

To further understand the diversity of our student’s situations and the barriers preventing them from considering pursuing scientific careers, we hosted an informal ‘food and focus’ event. Carer students indicated they found it difficult to manage studies alongside caring for dependents and that this would likely continue after graduation. International students were worried about the recognition of their degree topic in their home countries, and by the financial costs incurred by studying. Mature students raised issues around levels of generic skills (such as IT) and of transition to, and integration into University life. As a direct result we have developed some new initiatives, including:

  • commitment to running a Women in Science event annually
  • increasing the visibility of positive female role models with gender balance in speakers for extracurricular talks
  • running a careers event specifically for international students
  • facilitating confidence-building training sessions
  • organising a lunch early in stage 1 for mature and carer students, inviting attendees to establish a student-led group to inform further supporting initiatives
  • recruitment of mature student and parent student mentors

We will continue to review the impact of our undergraduate initiatives, with emphasis on the perceived barriers, and those groups raising specific concerns, and hope to increase the numbers of bioscience graduates entering scientific careers.

cerys

Carys Watts, School of Biomedical Sciences

michelle sweenyMichèle Sweeney, School of Biomedical Sciences

They co-chair the SBMS Equality and Fairness Athena SWAN Self-Assessment Team meetings and co-wrote the School’s Athena SWAN silver award application.

What we talk about, when we talk about feedback

Patrick RosenkranzEffective feedback practices lie at the heart of higher education teaching and learning, however across disciplines, feedback remains a cause of concern for students. Feedback provision seems to be one of the recurring themes that students bring up at staff-student committees, focus groups and surveys such as the NSS. Why is it so difficult to get feedback right?

A potential answer to this may be that students and staff have different assumptions, expectations and perceptions about what constitutes good and effective feedback. For instance, one thing that students seem to want to get from feedback is what explicit steps to take to improve their grades. However, most tutors want students to take a “deep approach” to learning, independently and reflectively engaging with the material. As a consequence, feedback fostering a “deep approach” may not include the detailed instruction that a student seeks for improvement of grades. So from a student’s perspective, this feedback does not give them what they want or feel they need and may lead to dissatisfaction.

In order to investigate these issues within the context of psychology teaching at Newcastle, we started a research project into feedback in our School. As part of the Careers service’s work placement, Matt Astle, a final year Politics student, is working as a research assistant on this project. In the first phase, Matt has conducted a literature review which incorporates feedback and assessment practices and perceptions across all disciplines, with a specific focus on the psychological literature. The result of this review is an accessible database of articles that forms a resource for further investigation and practice. The second phase of the project involves auditing colleagues in the School on their feedback practices and perceptions and comparing these to the perceptions and expectations of our students. Here the project converges with some of the other activities within the school:

For instance, Elisha Warren, a final year Psychology student, under the supervision of Val Tuck has conducted her empirical project on student perceptions of feedback in Psychology. The insights from her project as well as other sources of student perceptions, such as focus groups, will be brought together to identify and examine possible differences in expectations and perceptions between students and staff.

Ultimately, the aim of our research project is to better understand the processes involved in effective feedback and finding ways to improve our practice by clarifying and articulating what we, staff and students, mean when we talk about feedback.

Patrick Rosenkranz, School of Psychology