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Scotland Deanery

Scotland - home of medical excellence

Dentistry

Specialty Training - Dental Quality Management Framework

    Our Postgraduate Dental Dean (or Associate) is responsible for ensuring the quality management of postgraduate dental education and training to the standards set by the General Dental Council (GDC).

    The General Dental Council: Sets standards for ensuring that dentists are trained and are practising at an appropriate level. It is the regulator of undergraduate and postgraduate dental education in the UK to ensure that the health professionals listed on their registers are suitably qualified and fit to practise in the capacity in which they are registered.

    The Scottish Government: Supports and provides funding for the delivery of postgraduate medical and dental education in Scotland. Scotland Deanery is directly accountable to the Scottish Government as are all NHS Scotland health boards.

    Health Boards: the hospitals or clinics in which dentists undergo training. Dental education and training follows a curriculum that is approved by the GDC, therefore Health Boards have a responsibility to ensure its training environments can deliver the GDC’s curriculum requirements.

    Our Postgraduate Dental Dean (or Associate) oversees the training delivered by Health Boards by receiving regular reports and feedback from trainees and educators. We report to the GDC and the Scottish Government on the quality of undergraduate and postgraduate dental training programmes in Scotland.

    There are 14 territorial Boards and 2 State Boards (the Golden Jubilee National Hospital and the State Hospital) in Scotland.

    Image of Territorial Boards

    If you have any queries, please contact the Associate Postgraduate Dean for advice.

    The General Dental Council (GDC) has overall responsibility for setting and regulating standards for dental training in the UK. There are 3 levels of quality activity: quality assurance, quality management and quality control.

    Quality assurance is the responsibility of the GDC and is the overarching activity under which both quality management and quality control sit. It includes all the policies, standards, systems and processes that are in place to maintain and improve the quality of dental training in the UK.

    Quality management is the responsibility of programme providers, such as Scotland Deanery. It refers to the ways in which we are satisfied that our dental training programmes meet the GDC’s standards through robust reporting and monitoring mechanisms. We are able to do this by working in conjunction with medical Royal Colleges; faculties; trainees; trainers; service users; NHS hospitals and Health Boards. The UK Committee of Postgraduate Dental Deans and Directors (COPDEND) also plays a role in quality management.

    Quality control is the responsibility of Health Boards to ensure that the training environment in which trainees work continues to meet local, national and professional standards. It relates to the local arrangements (procedures and governance frameworks) within which trainees work.

     

     

    If you have any queries, please contact the Associate Postgraduate Dean for advice.

    The GDC’s Standards for Specialty Education (the Standards) outlines four overarching requirements for programme providers:

    1. Programme providers must have a quality framework in place that details how the quality of the programme is managed. This will include ensuring the necessary development to programmes/examinations that maps across to the GDC approved curriculum/latest learning outcomes for the relevant specialty and adapts to changing legislation and external guidance. There must be a clear statement about where responsibility lies for this quality function.

    2. Any concerns identified through the operation of this quality framework, including internal and external reports relating to quality, must be addressed as soon as possible.

    3. Quality frameworks must be subject to rigorous internal and external quality management procedures. External assessors must be utilised and must be familiar with the GDC approved curriculum/latest learning outcomes and their context.

    4. The programme provider must have systems in place to ensure the quality of placements/rotations to ensure that patient care and assessment in all locations meets these Standards. The quality management systems should include the regular collection of specialty trainee and patient feedback relating to treatment provided within placements/rotations.

    Other publications to take into account are:

    COPDEND’s Gold Guide for specialty training

    GDC’s Standards for the Dental Team

    COPDEND’s Standards for Educators.

     

    It is worth noting that the GDC has released a publication, Shifting the Balance, on the concept of ‘right touch’ regulation. It outlines the principles of good regulation as identified by the Better Regulation Executive in 1997, advising that regulation should be:

    · Proportionate – regulators should only intervene when necessary;

    · Accountable – regulators must be able to justify their decisions and be subject to scrutiny;

    · Consistent – rules and standards must work together and be applied fairly;

    · Transparent – regulators should be open and;

    · Targeted – regulation should focus on the problem.

     

    Our own quality management processes should reflect these principles.

     

    If you have any queries, please contact the Associate Postgraduate Dean for advice.

    The general principles for the quality framework management of Scotland Deanery training programmes are:

    1. Local quality management of training programmes must meet the regulator’s standards.

    2. Local quality management of training programmes will be undertaken in partnership with the specialties – represented by the Educators of the specialities and in partnership with Colleges and Faculties.

    3. Local quality management and review of training posts and programmes will be an integral part of training and service agreements between us and NHS Health Boards.

     

    If you have any queries, please contact the Associate Postgraduate Dean for advice.

    The Quality Framework is led by the Associate Postgraduate Dean within the specialty training committees (STCs) responsible for the overall management of the training programme. Organised in this way, the quality framework draws upon the local expertise of those directly involved in the training programme. This is ideal because it means that those with an in depth understanding of the structure of the programme and the local resources available can provide measured advice to the Postgraduate Dean about quality improvements. 

    Within the STC, sits the Training Programme Director (TPD). TPDs are appointed by the Associate Postgraduate Dean and are responsible for the day to day management of training programmes across posts and rotations for a specialty. TPDs allocate trainees to placements and contribute to local quality control processes at health boards. TPDs (and their STCs) are also expected to encourage trainees to engage with and complete survey tools.  

     

    If you have any queries, please contact the Associate Postgraduate Dean for advice.

    Our quality framework is based on the collection of evidence. The evidence has been mapped to the GDC’s standards to enable us to evaluate whether our programmes are meeting these standards and delivering a high quality training experience.

     

    Evidence is collected within a yearly cycle and includes: (1) the Scottish Training Survey (STS) to trainees; (2) the Joint Committee for Postgraduate Training in Dentistry (JCPTD) National Survey to trainees (3)(a) Annual Review of Competence Progression (ARCP) data; 3(b) certification guidelines as part of the Annual Review of Competency Progression (ARCP); (4) Specialty Training Committee (STC) data and 5) notifications of concern received (if any) in the previous 12-month cycle. Further details are provided below.

     

    Internal evidence

    1             Scottish Trainee Survey

    The Scottish Trainee Survey (STS) was conceived of in 2013 as a replacement to the Post Assessment Questionnaire. The driving aim was to have a survey that produces robust indicators for quality management. A further aim of the STS was to capture data about each post, rather than just once a year.


    2a           Annual Review of Competence Progression (ARCP) data

    The ARCP is a formal review of a trainee’s progression according to the evidence provided by the trainee. There are several outcomes that may be awarded (refer to Gold Guide for ARCP outcomes), and these are recorded in our database. If several unsatisfactory outcomes are awarded to trainees of a particular programme, this may indicate wider issues within the programme that ought to be addressed. It may also be an indication of exam failure that may need further exploration. Face to face meetings occur with trainees at ARCP feedback where areas of additional support may be explored.

    2b           Annual Review of Competence Progression (ARCP) - certification guidelines and checklists
    Each of our Dental Specialty Training Committees has produced a set of certification guidelines to identify what a trainee will normally be expected to have achieved during their training programme. The guidelines cover such aspects of training as: clinical and operative experience; operative competency; research; quality improvement; and management and leadership, with some benchmarking guidelines in training year 4 and year 6.

    Trainees and trainers should use the guidelines to inform decisions about the acquisition of technical skills and experiences of trainees during training and progress is monitored at regular intervals (usually once per year). The guidelines also help ensure that any necessary remedial action can be taken in a timely manner so that trainees can meet the overall guidelines by the time of completion of training. The guidelines are advisory and are implemented flexibly to ensure that no trainees are inappropriately disadvantaged.

    3             Specialty Training Committee (STC) data

    STCs are specialty-specific advisory committees which act on behalf of the Postgraduate Dean (or Associate) and deal with all aspects of specialty training, including implementing policies, standards and regulations for specialty training. Members of the STC have proximity to and involvement with trainers and trainees and are likely to be aware of evolving issues in training environments. They share intelligence they gather around the strengths and weaknesses of training in the posts in their training programmes with Training Programme Director at STC meetings. STC members may also be involved in quality improvement activities nationwide and as a result are best placed to share lessons and good practice.


    STCs may also be asked to respond to and clarify any issues that arise through this quality framework. STC membership includes a trainee representative to ensure trainee input is provided.

    4             Notification of concerns

    Concerns may arise at any time during training. Trainees and trainers can raise their concerns with us at any time. 

    If there are very serious training concerns, Postgraduate Deans or their deputy can, with Specialty Advisory Committee (SAC)* involvement, remove one or more groups of trainees from a setting or organisation. The final sanction would be the withdrawal of approval of the training placement or programme.

    *SACs are responsible for the development of curricula, devising assessments and examinations and making recommendations to the regulator on training.

     

    External evidence

     Information collected by external sources are also used as supporting evidence:

     1             Joint Committee for Postgraduate Training in Dentistry (JCPTD) Survey

    JCPTD runs an annual survey of Dental Specialty Training. It consists of generic questions about training such as supervision and the training environment and specialty-specific questions which relate to the curriculum. Results are published vie the JCPTD website.

    2             Health Improvement Scotland reports

    Health Improvement Scotland inspect hospitals to ensure that the environment is safe and clean and compliant with regulations.  Further information can be found at: http://www.healthcareimprovementscotland.org/about_us.aspx

    3             Evidence collected across other Directorates (Medicine, NMAHP, Pharmacy etc)

     

    There are instances when information collected by other Directorates may be relevant to dental specialty training.

     

    If you have any queries, please contact the Associate Postgraduate Dean for advice.

     

    We will initiate action where there are imminent concerns about patient safety or where inadequate progress has been made to address known concerns. Such action may include:

    · A meeting between the Postgraduate Dean (or Associate), the Training Programme Director and Clinical Director to discuss issues and agree to a course of action to be reviewed at a period defined by the Postgraduate Dean (or Associate).

    · A triggered visit. Visits will only be triggered because of persistent ongoing issues (where previous remedial measures have found to be been ineffective), if the Postgraduate Dean (or Associate) deem that a visit will be effective. Depending on the nature of the concern, trainees may be requested to meet with the visiting panel.

    · Withdrawal of a training programme (only occurs whether other avenues of remediation have been unsuccessful). 

    If you have any queries, please contact the Associate Postgraduate Dean for advice.

    Internal scrutiny of our processes is provided by the Dental Postgraduate Dean (or Associate). Annual Review of Competence Progression (ARCP) panels are attended by the Associate Postgraduate Dean. Associate Deans ensure that:

    - the panel was constituted in accordance to the Dental Gold Guide;

    - there was an appropriate pre-review briefing;

    - the lay representative was actively and appropriately involved;

    - the standard and consistency of the reviews were satisfactory; and,

    - that no decisions were made without a review of the complete set of documentation.

     

    Associate Deans:

    - Provide additional information for those instances where they have been concerns over the progress of a trainee/s.

    - Share information with the relevant STC.

    - Are encouraged to participate in peer review with other deans and attend a panel other than in their own Directorate.

     

    All members of ARCP panels must undergo training in Equality and Diversity every three years and must be trained specifically for their role. Specific training may include the completion of online ARCP training modules, a period of shadowing, or both.

     

    If you have any queries, please contact the Associate Postgraduate Dean for advice.

     

    The GDC’s Standards for Specialty Training requires external scrutiny from those appropriately trained and familiar with the GDC approved curriculum and their context.

    The Dental Gold Guide also requires external input at key stages of specialty training, such as at the Annual Review of Competence Progression (ARCP).

    We ensure appropriate levels of externality and scrutiny by Royal College and Faculty Representatives, University Reps, and Lay Representatives by including these within membership of STCs, ARCP panels, and recruitment panels.

     

    If you have any queries, please contact the Associate Postgraduate Dean for advice.




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