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General overview of Community Based Clinical Teaching in the UK

School of Dentistry. General overview of Community Based Clinical Teaching in the UK. Peter J Ash Director, Primary Dental Care Unit St David’s Hospital, Cardiff Hon. Senior Lecturer Cardiff University, School of Dentistry. What is ‘Community Based Clinical Teaching’.

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General overview of Community Based Clinical Teaching in the UK

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  1. School of Dentistry General overview of Community Based Clinical Teaching in the UK Peter J Ash Director, Primary Dental Care Unit St David’s Hospital, Cardiff Hon. Senior Lecturer Cardiff University, School of Dentistry

  2. What is ‘Community Based Clinical Teaching’ • Taking the teaching away from the main university site • Utilisation of resources not normally or easily found on campus • Buildings and equipment • Manpower • More suitable patients • Broaden the undergraduate experience • Realistic environment • High level of ‘hands on’clinical care

  3. Who can benefit? • Dental undergraduates • Hygiene and Therapy students • Dental Nurses • Other members of the dental team • Technicians • Administrative

  4. Where in the Curriculum? • Non clinical / observation • Dental, Hygiene and Therapy • From year 1 • Clinical care of patients • Dental undergraduates • Years 3, 4 + 5 (Year 1-2 in Graduate entry schools) • Hygiene and Therapy • Year 1 and 2

  5. Current Teaching in UK Schools • Dedicated ‘Primary Care’ Clinic • Part of Dental School, but separate location • Local to School, or distant • Linear or Block attendance • Shared facilities • Community Clinics and Access Centre • Usually local General Dental Practice

  6. Dedicated Primary Care Clinic • Part of the Dental School • Managerially accountable • Academic control • Assessment process in place • Rotation, or training of staff • Separate location • Better patient mix, and experience • Ability to treat the ‘whole patient’ • Realistic environment

  7. Community Clinics and Access Centres • Realistic environment • High level of clinical experience • Separate managerial control • Academic standards • training of staff / student assessment • Financial constraints and funding implications • Patient mix • Children, special needs • Emergency adults • Less opportunity to complete total care

  8. General Dental Practices • Very realistic environment • Good patient mix • Separate managerial control • Academic standards • Training of staff / student assessment • Financial constraints and funding implications • Security of long term availability

  9. Challenges to Community Based Clinical Teaching? • Site • Easy commuting distance • Distant – residential need • Financial cost to student or university • Level of competence of students • 3rd, 4th, or 5th year? • Pattern of attendance • Block, or linear

  10. Advantages • Utilising the wide experience of other staff and members of the dental team • Improve student experience • Increase clinical activity and decision making • Promote effective and efficient practice • Improve communication skills • Promote working in a team environment • In final year, provide a bridge between supervised and unsupervised practice

  11. Realism • ‘Real’ patients • Student interaction with patient • Ability to complete a whole course • of treatment • 1:1 nursing • Teamwork

  12. Realism • Layout of surgery • Non ‘hospital type’ booking system • Electronic Patient Record • Use of commercial laboratories • Supervising staff • - Established practitioners • Vocational Training Advisors

  13. Current Teaching in Cardiff • Years 1 and 2 • Observational visits at St David’s • Year 4 - 5 • Clinical experience at St David’s • Clinical experience in CDS • General Practice visits

  14. Primary Dental Care UnitSt David’s Hospital, Cardiff • Situated within a peripheral hospital 3 miles from main campus • 10 open clinic chairs, 2 enclosed surgeries • 1 day per week for last two months of year 4, and whole of year 5 • Groups of 10 plus 2 Hygiene or Therapy students • All ‘practice’ type patients, inc inhalation sedation • Qualified Dental nurse per student • Ability to carry out ‘courses’ of treatment • 6.75 hrs clinical, and 1.15 hrs seminar / debrief per day • Teaching ratio 1:6 • Fully paperless with electronic patient record (Salud)

  15. Enhancing the Education • Informal ‘Peer Review’ Treat as ‘colleagues’ – open discussion • Debrief sessions Everyone learns! • ‘Transitional’ seminars, student lead • Training for the whole team • Audit 3-4 month projects

  16. Enhancing the Experience • Practice visits (no patients) • Discuss managerial and organisational • arrangements with experienced GDP’s, • Practice Managers, and staff • Greater use of IT • Students control appointments (0.5 hr slots) • Monitoring of work totals and grades • Adaptable system for multiple sites

  17. Future Teaching in Cardiff • Mountain Ash Primary Dental Care Unit • 2011 intake • 18 chairs • Area of high dental need • Years 4 / 5 (12) • DCP’s (6) • Design evolved from experience

  18. And after Mountain Ash? Bangor!

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