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B. Grieveson, J. A. Kirton, N. O. A. Palmer, M. C. Balmer British Dental Journal 2011; 211: E8

Editor's summary

With the vocational training (VT) scheme now so well established that it has earned itself an upgrade in title to the very much grander foundation training (FT), it is easy to forget that the original idea was generated from the profession itself. This is significant in that, unlike other schemes, regulations and directions imposed upon the profession from elsewhere, the roots of its undoubted success were established by a need identified by practitioners themselves and subsequently formed and implemented by them.

Thus, the conception of the scheme was based on the identification of a gap in professional training and its genesis on the very reflection that this piece of research takes even further. It is then perhaps odd that such a move has taken nearly 20 years since the mandatory application of the VT scheme to come about. However, much has had to be organised, decided, debated and adjusted in these intervening years and any system which ultimately attempts to match the characteristics and foibles of two individuals (as in trainer and trainee) with the interests of at least the patient as the third party and arguably the NHS as a fourth, was never going to be an easy blueprint to establish.

Any tool or system which helps to clarify and improve the quality of training has to be welcomed and the use of workplace based assessments in this piece of research indicates that such a method does indeed show advantages. The likelihood of a need for increased educational capacity outside the traditional dental school environment is growing as dental practise becomes increasingly sophisticated and within which changes happen so swiftly in a technologically driven world. Consequently the application of educational theory and knowledge to the development and assessment of such ongoing professional development is not only desirable but arguably needs to be as mandatory as the scheme itself.

Finally, in anticipating the use of FT instead of VT, I wonder how the application of the 'other' FT's slogan might fit: 'No FT, no comment'.

The full paper can be accessed from the BDJ website ( http://www.bdj.co.uk ), under 'Research' in the table of contents for Volume 211 issue 4.

Stephen Hancocks, Editor-in-Chief

Author questions and answers

1. Why did you undertake this research?

Workplace based assessment has been part of medical foundation training for some time but very little research has been done in evaluating workplace based assessments in dental foundation training. The literature published on medical foundation training was not conclusive on the effectiveness of these training tools. As workplace based assessment is an integral part of the dental foundation personal development portfolio, it is important to evaluate its effectiveness as we move towards satisfactory completion of dental foundation training. The Mersey Deanery had already been using some of workplace based tools so the group of DF1 Mersey trainers and trainees were used for the first study carried out online using SurveyMonkey™.

2. What would you like to do next in this area to follow on from this work?

With a further grant from COPDEND the study has been extended across all English Deaneries, using a bigger cohort of trainees and trainers to explore how effective workplace based assessments have been in improving feedback and insight to the performance of dental foundation year one trainees. The results of this further research will be submitted for publication in due course and used to develop any further changes to the workplace based assessment in use and inform further developments of the dental foundation personal development portfolio.

The group would also like to explore the effectiveness of workplace based assessments in dental speciality training when used in the dental speciality curricula.

Commentary

Dental foundation training (DFT) is a two year programme of training and education, based in the workplace, grounded in the DFT curriculum and guided by a professional development portfolio. All UK graduates must complete the first year (DFT1) to get an NHS performer number; the second year (DFT2) is optional and usually based in the secondary care sector.

Formative assessments performed throughout the two years and structured within the portfolio help the training pair to monitor the trainee's progress. Assessments can be planned using the curriculum as a guide and therefore cover a wide scope of practise.

The results presented in this paper by Grieveson et al. highlight the perceived value of regular and carefully structured feedback during the DFT1 year in the Mersey Postgraduate Dental Deanery. The activities of observation of the trainee's work, case presentation and one to one discussion followed by accurate feedback form a major part in monitoring the trainee's progress. The authors demonstrate that these activities are thought to be useful by both trainers and trainees, not only as an assessment tool but also as a guide to improving performance. Regular observation and assessment improves performance.

Multisource feedback adds veracity to the assessment of the young dentist and the patient assessment questionnaire is one element of this. I agree with one of the responses in the survey that patients can sometimes be very kind to their young dentist, perhaps an example of regional bias mentioned by the authors. Rolling out this survey to other regions or nationally would seem to be the next step.

The paper also leads on to the consideration of the training needs of trainers. They have a vital role in the development and nurturing of young professionals. Training in accurate assessment and feedback is essential to develop the skills that trainers need to successfully perform this role.