MED-NET Conferences 1998, Lille & 1999, Maastricht
Anthology of presentations 2.6.

2.6. DENTED, a new thematic network in dentistry education

D. Shanley (Dublin, Ireland)

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Achieving convergence towards higher standards in European dental education

Thematic Network Projects (TNPs)

• Trans-national groups who put Europe into practice
• Trusted by members to represent their interests
• Permit a diversity of models achieving similar aims
• Total of >30 discipline-based networks

Dentistry in the European Union

• 15 Countries (expanding to 26)
• 15 national dental associations
• >120 dental schools
• Almost 10,000 dental academics
• Almost 200,00 dentists
• Almost 400,000,000 people
• 26 dental institutions/specialist associations representing divergent interests…..some unaware of the others’ existence !

Background to DENTED

• Dental Directives 1976
• Advisory Committee on Training of Dental Practitioners (DGXV)
• Pilot study comparing self-assessment and site visits 
• Association for Dental Education in Europe
• Proposed European College
• Socrates Thematic Network Projects (TNPs) DG XXII

Membership of DENTED

• ADEE
• Members of the WP of the ACTDP
• >50 Dental Schools (out of 120)
• 5 National Dental Associations
• 4 National Dental Education Associations
• Linked to MED-NET
• ? Specialist organisations
• ? Dental Commercial Organisations

Any future developments in European dentistry (and other professions once covered by the Sectoral Directives) will need to be achieved through international agreement and peer influence rather than by imposition or legislation

Objectives

• Establish a Network in dental education 
• Promote better understanding of each others systems
• Share innovations and good practices
• Promote convergence towards higher standards through peer exchange and without prescription
• Promote evidence-based clinical teaching/treatment
• Agree common competences in Primary Health Care
• Develop an incremental and interactive electronic bulletin board for European information

Explore Possibilities

• Peer reviewed interactive learning programmes on the Internet
• Advance multi-Media Conferencing
• Encouraging compatible IT programmes & media systems in all schools in network
• Diagnostic Services & "virtual" training 
• Medium for explaining and collaborating in EU policies & grants

Facilitate EU Exchange

• Programmes including CAL packs.
• Internet courses
• Technologies
• Patient Services Systems
• Financial & Management Packages
• Staff/Students
• Virtual staff
• Collaboration & development with IFDEA

Information required before visit

• Staff, facilities & resources, student numbers
• Educational objectives
• Approach & curriculum
• Assessment methods
• Competences and their assessment
• Innovations
• Good practises 

Conclusions of the pilot studies

• Significant variation between schools, regions and countries in the interpretation and application of the EU Dental Directives
• Significant differences between schools in interpretation of the questions asked 
• EU directives are ineffective !

"The Commission is pleased to note that the principal objectives for which the advisory committees on training were originally set up have been attained overall"
EU Commission - SLIM Report 1998

Self-assessment

• Self-assessment is a useful reflective exercise for the staff in reconsidering their own priorities
• It does not resolve the problem of misinterpretation
• It provides useful but often misleading information for purposes of comparison
• It is subjective and (unintentionally) can hide a fundamental and/or recurring problem

EU Advisory Committee on the Training of Dental Practitioners

• Dental Directives
• Competences
  • undergraduate
  • two specialist categories
• Core knowledge required for competences

Clinical Competence
Denotes a combination of skill, attitude and knowledge which provides the clinician with sufficient competence to undertake a specific clinical task. The requisite knowledge embraces an appropriate understanding of the molecular biological principles including the relevant pre-clinical, para-clinical, behavioural and clinical sciences. Clinical competence implies much more than simply a clinical skill.

Inherent elements of Competence

• An understanding of the aetiology, pathology, demographic features, treatment and prevention of the disease 
• An understanding of the relevant basic, biological, behavioural and medical sciences
• Treatment must be evidence based and provided within the context of holistic care
• Within acceptable ethical parameters
• Prioritised within the context of the environment, society needs and health promotion
• An understanding of the related pharmacology and therapeutics
• An understanding of the relevant biomaterial sciences
• An understanding and application of effective cross infection control
• Appropriate anxiety and pain control
• Application of quality assurance in practice

Core knowledge & Understanding

• Within a broadly based third level education
• Sufficient understanding of the basic sciences to understand the molecular/biological sciences
  Sufficient understanding of the biological science to understand the para-clinical sciences
• Sufficient basis in the pre & para-clinical and behavioural sciences (including communication skills) to understand human diseases
• A sufficient awareness of human diseases to provide oral health treatment and prevention as an integral part of holistic patient care in a public health context

Evidence-based treatments

• Health care decisions are based on values & resources
• Clinicians & teachers will be challenged to provide evidence in relation to each clinical decision
• Evidence-based practice in consultation with the patient and the funding agency will increase
• Treatment provided in future will have to be based on a systematic appraisal of the best evidence available; preferably based on hard science

Site Visits from Peers

• Provide an accurate and objective insight as to what a school is actually achieving
• Provide an opportunity to exchange opinion and constructively debate with peers
• Provide a basis to demonstrate and share innovations and good practices
• Act to serve as a mirror for those visited to reflect on their own perceptions of the strengths and weaknesses of their programme

The purpose of site visits

• To inform visitors of the rationale for the educational approach taken and see the outcome 
• To understand and support one another
• Help validate legitimate requests for resources
• To provide an opportunity to present self assessment analysis to a peer group
• To educate both the visited and the visitors
• To identify and share innovations and best practices
• Promote quality in health care services
• To establish a broader dental educators community

Site Visits from Peers
(non-prescriptive)

• Must not attempt to impose a new curriculum
• Must not be threatening or negative
• Must not imply inspection or accreditation
• Must be sensitive to the school’s objectives
• Understand regional priorities, culture and resources
• Should identify & commend strengths 
• Might assist in resolving agreed shortcomings
• Both visitors and those visited should benefit
• Avoid hypocrisy & arrogance

Self Assessment
(Reader friendly& avoiding minutiae)

• Educational philosophy and approach
• Anticipated outcomes
• Curriculum content and design
• Objectives and priorities
• Strengths & weaknesses
• Particular innovations of school
• Exercise should be beneficial to the school

Potential Disadvantages

• Costly
• Considerable preparatory work
• Fear & insecurity
• Imposition of views or narrow perspective
• Prescriptive report (must be agreed)
• Application of traditional "visitation systems"
• Unhelpful publicity of difficulties
  

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