Professor Jonathan Cowpe FFGDP(UK) discusses the findings of the independent review he led into professionalism in dentistry, and considers how the College of General Dentistry will enable its members to achieve the high level of professionalism expected by patients and fellow professionals.
The review into professionalism in dentistry and other healthcare professions, which was commissioned and published by the GDC, covered all aspects of a dental professional’s career, including the periods of undergraduate and postgraduate training and when working as an established dental professional. The Report was completed by a project team under the auspices of the Association for Dental Education in Europe (ADEE). The views and opinions, expressed below, are those of the author and do not necessarily reflect the views of the GDC.
The project team considered over 1,000 publications on professionalism, from across the UK and internationally. The rapid evidence assessment (REA) of these publications provided significant detail from 92 relevant documents. The team also interviewed 13 research area experts and ran a total of nine focus groups, for dentists, dental care professionals (DCPs, allied dental team members) and members of the public. In addition, it received over 1,000 responses to a two-stage Delphi survey. Some team members also hosted a panel session as part of the GDC stakeholder event – ‘moving upstream’ - in February 2020.
The data we collected exceeded expectations, not least the online survey, which received ten times the number of responses we anticipated. The study highlighted the importance to patients of being treated in a safe healthcare environment, and that they expect good clinical skills from dental professionals. In addition, patients expect professionals to communicate and engage with them appropriately – put them at their ease and involve them in decision making about their treatment, so that they ultimately have trust in those who care for them. Evidence of good teamwork and continuing education and training were also important to patients.
The patient’s experience of interactions with dental professionals and their expected service experience, as well as the personal and professional divide that is relevant to all healthcare professions, were key areas of professionalism that were highlighted in the review.
One of the major influences on professionalism that was also emphasised, was the importance of the context in which professional behaviour is interpreted. A one-off lapse, with minimal implications, which was out of character was understandable by professionals and patients alike, as long as the individual learnt from this experience and could personally move on. Dwelling on a lapse, by a professional, rather than learning and moving on was seen by all concerned as detrimental to that professional both from a mental health and from a clinical service perspective.
The impact on an individual, of ‘unprofessional behaviour’ whether proven, or even more so not proven, puts an immense amount of pressure on the practitioner. This, in turn, can impact on their ability to deliver care for their patients, how they interact to their peers and team members, friends, and family. It is important for all concerned to identify support mechanisms that can help professionals through difficult times and help them to move on.
The issues of ‘wellbeing’ and ‘resilience’ are increasingly areas being addressed through online training opportunities which can only help to strengthen individuals’ professional behaviour and response to difficulties they may encounter.
In many ways, the key findings drawn out here from the professionalism review are mirrored in the vision and aims of the College of General Dentistry, specifically in its planned Career Pathways and Professional Framework. A safe healthcare environment, good clinical skills, patient-centred clinical decision making, evidence of effective team work and continuing training are all considered to be important aspects of professionalism by patients and lead to enhanced public trust in oral healthcare.
One of the College’s key visions is to ‘foster excellence and confidence in oral healthcare, for all’ and this is in part achieved through a focus on professionalism and a commitment to patients’ interests. A patient-centred approach to clinical decision-making is one of the key elements in the College’s Career Pathways and related membership structure, that is being defined and set out for the whole dental team.
The College recognises the importance of a team-based approach to patient care, and the Career Pathways will promote a structure that encourages life-long learning through its education and training programmes.
Furthermore, the Professional Framework, which underpins the Career Pathways, has five domains which include ‘Professionalism’ and ‘Reflection’. As stated in the Framework, these centre on ‘the conduct and behaviour to engage patient trust and confidence’ and ‘awareness of personal impact, abilities and limitations’ respectively.
Through the establishment of the new College, there is an aspiration to be open and transparent, and to engage across the profession and with members of the public to ensure a high standard of professional and clinical practice, demonstrable by all dental professionals, through shared ownership of their needs and skills. The College’s commitment to prioritise a patient-centred approach to oral health care, as well as provide a much-needed structure for skills and career development within the profession, will serve to improve professionalism in dentistry. In turn, this will hopefully strengthen patient trust in their oral healthcare, benefitting the oral health of the nation.
Further details and findings from the four research areas explored in the review are available here.
A recording of an online presentation of the research, hosted by the GDC, is available here.
It is intended that FGDP(UK) will transfer to the College of General Dentistry on 1 July 2021. Membership of the College of General Dentistry has recently opened, and is available exclusively to FGDP(UK) Members, with eligibility automatic, and only a temporary nominal fee payable until the point of transfer. Join here.
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