Faculty - Newcastle University, Newcastle upon Tyne, United ...

Monospeciality Training in Prosthodontics

4 Year Programme

Handbook 2003-2007

CONTENTS

FACULTY.................................................................................................................................. 3

Introduction and Entry Requirements.....................................................................................4

Overall Aims and Learning Outcomes.....................................................................................5

Outline of Programme Structure.............................................................................................. 6

Progression................................................................................................................................. 6

Programmed Hours of Training............................................................................................... 7

Sample Timetables..................................................................................................................... 9

Years 1 & 2 Overview.............................................................................................................. 10

Years 3 & 4 Overview.............................................................................................................. 12

Years 3 & 4 Prosthodontic Modules.......................................................................................14Advanced Implantology......................................................................................................... 15Advanced Clinical Prosthodontics.......................................................................................... 16Maxillofacial Prosthodontics.................................................................................................. 17Prosthodontic Technology..................................................................................................... 18

Generic Modules...................................................................................................................... 19Inter-disciplinary Care........................................................................................................... 20The Medically Compromised Patient.....................................................................................21Evidence Based Learning....................................................................................................... 22Management, Team Building and Interpersonal Skills...........................................................23Clinical Governance and Audit.............................................................................................. 24The Specialist Practitioner and Education..............................................................................25Specialist Dental Practice: Management, Ethics and Medico-legal Aspects...........................26Preparation for the MRDRCS Examination (Prosthodontics).................................................27

APPENDIX 1..................................................................................................................28

Aims and Learning Outcomes: Clinical Domain...................................................................28

APPENDIX 2..................................................................................................................29

Aims and Learning Outcomes: Academic Domain................................................................29

APPENDIX 3..................................................................................................................30

Aims and Learning Outcomes: Research Domain.................................................................30

MONOSPECIALITY TRAINING IN PROSTHODONTICS – Handbook 2003-2007 1

APPENDIX 4..................................................................................................................31Time commitment years 1 & 2– full time trainee...................................................................31Time commitment years 1 & 2 – part time trainee.................................................................33Analysis of years 1 & 2 and years 3 & 4 relative to 4500hrs..................................................35


Faculty

Mr F S A Nohl, MBBS, BDS, MSc, FDSRCS(Eng), MRDRCS(Eng), FDSRCS(Rest), DDS

Consultant in Restorative Dentistry, Newcastle upon Tyne Hospitals NHS Trust. (Monospeciality programme director).

Mr S C Barclay, BDS, MSc FDSRCS(Edin), DRD MRDRCS(Edin)

Consultant in Restorative Dentistry, Newcastle upon Tyne Hospitals NHS Trust.

Mr DJ Jacobs, BDS, FDSRCS(Edin), DRDRCS (Edin)


Dr N J Jepson, BDS, PhD, FDSRCS

Senior Lecturer and Honorary Consultant in Restorative Dentistry, Newcastle Dental School.

Mr D G Smith, BDS, DRD, FDSRCS(Edin), FDSRCS Eng


Dr J.G Steele, BDS, PhD, FDSRCPS.


Dr J M Thomason, BDS, PhD, FDSRCS(Edin).


Professor A W G Walls, BDS, PhD, FDSRCS.

Professor of Conservative Dentistry and Honorary Consultant in Restorative Dentistry, Newcastle Dental School.

Dr R W Wassell, BDS, MSc, PhD, FDSRCS.



Introduction and Entry Requirements

The 4-year programme at Newcastle includes the MSc in Restorative Dentistry as a foundation with further training in the chosen Monospeciality. The proportion of the Monospeciality element of training increases throughout the programme, particularly the clinical component. For details relating to the MSc in Restorative Dentistry please refer to the current MSc Course Handbook and Course Specification which should be read in conjunction with this document.

The MSc Course Handbook explicitly distinguishes between application and admission for the MSc degree programme and that for Specialist Training. It states that transfers from the MSc degree programme to a Specialist Training programme are not possible after entry to the MSc.

Applicants for Specialist Training must be in possession of MFDS, FDS or have equivalence granted by the Equivalence Sub-committee of the Joint Committee of Specialist Training in Dentistry (JCSTD). The admissions process will involve the Postgraduate Deanery to ensure compliance with entry requirements, appropriate competitive selection and allocation of a National Training Number (NTN). Specialist trainees will hold an NTN; degree-only candidates will not.

Applications are welcome from both part-time and full-time trainees up to a maximum of three trainees per year (including all Monospecialities).

The University distinguishes between part-time and full-time MSc students on the basis of a part-time student being able to submit approved and planned work carried out in practice as part of his or her course requirements. In this way it is possible for both part-time and full-time trainees to complete the MSc programme in 2 years. In the same way a proportion of specialist training can be carried out in practice during years 3 and 4 allowing both part-time and full-trainees to complete the programme in 4 years. Hence the terms part-time and full-time relate to faculty attendance and, in reality, the amount of time each type of trainee commits to the programme is not significantly different.

The part-time training posts are designed principally for dentists with GDC registration who are employed locally in practice, hospital, community services or the armed forces where a proportion of specialist training can take place. However they will be required to discuss the treatment planning and progress of all training cases, at various stages for scrutiny by their trainers in the Dental Hospital and School.

Part-time trainees are expected to spend at least 60% of their time on Faculty premises (normally 3 days a week unpaid with access to 4 clinically related sessions per week at the Dental School) and to carry out a significant proportion of research or seminar preparation out with this time.

The full-time training posts will appeal most to overseas dentists who do not have GDC registration and do not have a suitable position locally where a proportion of specialist


training can take place. Therefore full-time trainees have unpaid access of up to 6 clinically related sessions per week at the Dental Hospital.

Overall Aims and Learning Outcomes

The aim of the Monospeciality training programme in Prosthodontics is to enable appropriately qualified dentists to acquire advanced skills, knowledge and research experience in the field of Prosthodontics. This will enable them to sit the Membership in Restorative Dentistry of one of the Royal Colleges, and if successful to be issued with a certificate of completion of specialist training (CCST) and to be registered by the GDC on the specialist list in Prosthodontics. Satisfactory completion of the MSc in Restorative Dentistry at Newcastle School of Dental Sciences will be used to inform the Record of In-Training Assessment (RITA) at the end of year two as an indicator of satisfactory completion of the first two years of the Monospeciality programme.

The MSc programme provides trainees with most of their research requirement and, as detailed below, year two of the programme is structured to reflect the emerging specialist. The broad aims and objectives of the MSc programme are contained in the MSc Programme Specification as well as the MSc Course Handbook. These aims complement those of Monospeciality training which are:

To acquire advanced knowledge in clinical Prosthodontics including implantology and maxillofacial Prosthodontics as well as the integration of Prosthodontics with other specialist care.

To demonstrate an understanding of Clinical Governance, including risk management, the ethical and medico-legal aspects of Specialist Dental Practice and practical experience of clinical audit.

To acquire knowledge about the management of Specialist Dental Practice.

To understand the importance of the educational role of the Specialist Practitioner and to have experience of Undergraduate clinical teaching, delivery of MSc seminars and involvement in the provision of Postgraduate courses.

A more detailed exposition of the aims and learning outcomes associated with the clinical, academic and research domains of the programme are contained in Appendices 1-3 while the specific aims of individual programme modules are contained in:

The MSc module guides

The module outlines specific to the Monospeciality (referred to in this document)

The module outlines generic to all Restorative Monospecialities (also referred to later).

The specialist trainee will be required to compile a log book which meets with SAC approval and to participate fully in the RITA process from the time of entry onto the Specialist training programme.


Outline of Programme Structure

The JCSTD curricula for each Restorative Monospeciality specify that training should be broad based in all aspects of restorative dentistry and clinical dental science. The MSc programme provides the broad clinical and scientific foundation to Monospeciality training. However as the programme progresses trainees will require an increasingly sharp focus on their speciality area. For this reason trainees will undertake an MSc research project in their chosen Monospeciality. In addition year 2 of the MSc programme will have:

The majority of supervised clinical sessions entirely Monospeciality based The four patients reviewed by the internal examiners at the end of the second

year chosen to exhibit treatment of Monospecialist nature (MSc students are expected to submit cases of a general restorative nature at the end of both year 1 and year 2)

Current literature review sessions to allow trainees to keep abreast of targeted journals of importance to the Monospeciality.

The modules for Years 3 and 4 have a large clinical emphasis to support specialist training. Academic topics comprise Monospeciality specific subjects (e.g. Implantology and Maxillofacial Prosthodontics) and generic subjects common to all three Restorative Monospecialities which have not already been introduced in years 1 and 2.

Where appropriate, subjects introduced during years 1 and 2 are extended in years 3 and 4. For instance, a trainee would be expected to attend audit and clinical governance meetings in the first year, identify a subject for audit in the second year, perform and report the audit in the third year and where possible re-audit to complete the audit cycle in the fourth year.

It should be emphasised that during years 3 and 4 trainees will be expected to engage more and more in directed self-learning.

Certain educational activities will be linked with the Restorative Trainees (e.g. current literature reviews and appreciation of evidence based dentistry).

Progression

Progression from year 1 to year 2 relies on the trainee passing the MSc written examinations and submission of the research literature review. Should a trainee fail the written papers he or she may re-sit during the month preceding re-registration for the second year (i.e. during September).

In order to progress to years 3 and 4 Trainees must complete the MSc programme as part of their training and pass the University examinations, with the possible exception of the research project oral examination. In such a case the experimental work for the project would still need to be completed in Years 1 and 2. Trainees must however MONOSPECIALITY TRAINING IN PROSTHODONTICS – Handbook 2003-2007 6

realise that the MSc must be passed as a whole to be awarded a CCST (certificate of completion of specialist training).

Specialist trainees will participate in the RITA exercise and any future Competence assessments specified by the SAC in addition to other programme assessments of a formative and summative nature. The RITA processes are scheduled at 6, 12, 24 and 36 months.

It must be emphasised that unsatisfactory progress, including failure of one or more components of the MSc examination, would normally result in the award of a RITA ‘D’ or ‘E’ form. Award of a RITA ‘D’ would involve the trainee undertaking targeted or remedial training within the period of their training programme; while a RITA ‘E’ requires a repetition of, and an extension to training. The trainee would be responsible for funding any such extension to training. Where the RITA panel detects continued unsatisfactory performance it will recommend to the Postgraduate Dental Dean and, during years 1 and 2, the Graduate School Dean, that training is discontinued.

Programmed Hours of Training

The required numbers of hours, in the various years, to comply with SAC approval are shown in Appendix 4. In order to provide at least 4500 hours of training our Monospeciality programmes have been designed over a four year period (see calculations in Appendix 4). Specimen weekly timetables for years 1, 2 and 3&4 are shown below. Part-time trainees are expected to use a proportion of their own clinical time to undertake training in their practice setting.

Year 1

Based on academic year

Module Activity Weekly sessions

Total hrs+

Clinical Personal patient treatment 4 342

Diagnostic clinics 1# 120

Academic Restorative literature seminars 1 563

Research Lit rev and programme of work 1 310


Year 2

Based on academic year


Total hrs+

Clinical Personal patient treatment 3* 420

Diagnostic clinics 1 30

Undergraduate teaching 1# 60

Academic Current literature review 1 255

Research Complete project and write-up 1 450

Years 3 & 4

Based on 40 hour week


Total hrs (2 years)

Clinical Personal patient treatment 4 *

1680 (full time)

1320 (part time) *

Diagnostic clinic 1

Undergraduate, postgraduate and Section 63 teaching

1

Academic Thematic literature 1 610

Current literature 1

Research ** 25hrs/yr

# For Full-time trainees only

* Part-timers can see patients 2 of these sessions/week in practice. Only one third of the total time spent in practice during the programme is recognised as training time where there is no specialist practice trainer (JCSTD A Guide to Training and Training Posts in Restorative Dentistry Sept. 2001, Appendix 5, p39). If this option is taken part-timers will have 1320 hours of clinical time in the hospital compared with 1680 hours for full-timers.

** It is assumed that 3rd and 4th year trainees will continue to be engaged in research activity, such as the preparation of research papers, review articles, case reports and preparation for scholarly presentations. This is over and above the formal research component of training detailed in years 1 and 2.+ Total hours takes account of directed self learning and non-clinical modules.


Sample Timetables

Changes may be made to suit the needs of individuals

Year 1

Monday Tuesday Wednesday Thursday Friday

am Seminars Personal treatment

Diagnostic clinic # Personal

treatmentSeminars/ Research

pm DSL# Personal

treatmentDSL

# Personal treatment

DSL#

Year 2


am DSL# Personal

treatment / DSLDiagnostic clinic Personal

treatmentDSL

#

pm DSL# Personal

treatment /

Diagnostic clinic

DSL# Personal

treatmentUndergraduate

Teaching#

Years 3 & 4


am Study/admin# Personal

treatment#

Personal Treatment Personal treatment

Personal

treatment#

pm Current literature

Undergraduate clinical teaching

Thematic literature Diagnostic clinic

Study/admin#

# for full-time trainees only

DSL Directed Self Learning


Years 1 & 2 Overview

Clinical DomainClinical activity comprises:

Clinical skills training during 1st term

A laboratory course during 1st term with trainees encouraged to make some indirect restorations for their patients

Supervised personal treatment.During the first year patients are allocated to trainees by their clinical supervisors in Conservation, Endodontics, Periodontics and Prosthodontics to give broad Restorative experience. During the second year patients are allocated to focus experience in the Monospeciality.

Attendance at diagnostic clinics.

Undergraduate teaching (for full-time trainees) See generic module The Specialist Practitioner and Education.

Weekly Case Discussion Forum.

The following modules are undertaken during years 1 and 2:

Introduction to Implantology.

Occlusal management

TMD management

Introduction to sedation

And the following modules listed on p18 are started:

Clinical governance and audit

Interdisciplinary care

Management of the medically compromised patient

Evidence based dentistry

Academic Domain

Restorative literature reviewSeminars based on chapters from texts and key journal publications. Trainees are expected to prepare revision notes on each topic and essays on selected topics. Trainees are expected to present some seminars within Dental Materials Science.

Medical statisticsA series of 13 seminars complementing the research dissertation.

Research DomainTrainees are allocated a supervised research project within their chosen Monospeciality which should be completed within two years (see note on extended projects p6). The dissertation is written up as a literature review combined with a manuscript ready for submission to a targeted journal.


Assessment

Formative:

1. Quality of clinical skills work [Term 1]

2. Feedback from clinical trainers and patients [Sessional]

3. Essay writing and practice for MSc examination [Year 1]

4. Literature review [Year 1]

Summative:

1. MSc written papers [Year 1]

2. Verbal presentation of 4 treated cases [Annual]

3. Fully documented restorative case presentation [Year 2]

4. MSc vivas [Year 2]

5. MSc dissertation [Year 2]

6. RITA


Years 3 & 4 OverviewClinical DomainClinical activity comprises:

Supervised personal treatment.Patients are allocated to trainees by the training programme director according to training requirements.

Attendance at diagnostic clinics.

Undergraduate teaching. See generic module The Specialist Practitioner and Education.

Treatment carried out either in practice or in a paid hospital post under the guidance of a specialist trainer.

Weekly Case Discussion Forum.

The following clinical modules are undertaken throughout years 3 and 4:

Advanced Implantology.

Advanced Clinical Prosthodontics and Inter-disciplinary Care.

Maxillofacial Prosthodontics.

Prosthodontic technology.

Aims and learning outcomes are detailed below.

Academic Domain

Thematic literature reviewBased on chapters from texts and key journal publications. Trainees prepare summary sheets on each topic.

Current literature reviewOne session per month will be devoted to reviewing current literature from a list of journals held in the library. Articles may be added to the thematic literature review.

Research DomainIt is assumed that 3rd and 4th year trainees will continue to be engaged in research activity, such as the preparation of research papers, review articles, case reports and preparation for scholarly presentations. This is over and above the formal research component of training detailed in years 1 and 2.

Assessment

Formative:

1. Contribution at Case Discussion Forum [Weekly]

2. Contribution at current literature review groups [Monthly]

3. Feedback from clinical trainers and patients [Sessional]

4. Summary sheets on thematic literature [Termly]


Summative:

1. Essays on thematic literature [Termly]

2. Written documentation of 3 treated cases [Annual]

3. RITA [Annual]

4. MRD


Years 3 & 4 Prosthodontic Modules

Individual module specifications (combined clinical and academic) follow for years 3 and 4:

Advanced Implantology

Advanced Clinical Prosthodontics and Inter-disciplinary Care

Maxillofacial Prosthodontics

Prosthodontic technology

Each will be supported by the thematic literature assignments and literature which emerges from the Current Literature Review.


Advanced Implantology

IntroductionThis module is designed to provide advanced training in implantology to supplement the basic training provided during years one and two (the MSc course).

AimsTo provide: A thorough knowledge of the scientific basis of osseointegration. An in-depth understanding of patient selection, systemic considerations and treatment planning for dental implants. An awareness of the role of additional specialists in implant provision. An awareness of the extra-oral applications of osseointegrated implants. Theoretical and practical experience of surgical procedures as they relate to the provision and reparative management of

intra-oral implant borne restorations. A detailed knowledge of the clinical and laboratory stages in the provision of implant superstructures. A familiarisation with maintenance requirements and implant complications.

Learning OutcomesBy the end of the course the trainee will be expected to: Identify and advise patients who may benefit/seek implant restorations. Carry out thorough assessment, including appropriate investigations, for patients who may benefit from dental implant

restorations. Undertake the surgical procedures necessary to provide dental implant restorations. Carry out the clinical stages in the provision of dental implant superstructures including effective communication with

the laboratory. Instigate and carry out an appropriate maintenance regime for patients with dental implant restorations.

Assigned tasksClinical Attendance at designated interdisciplinary implant planning and surgical clinics. Personal clinical treatment of edentate and part-dentate patients who require implant restorations.

Academic Completion of assigned thematic reading and current literature review. Presentation of cases for discussion with trainee colleagues from all specialities of Restorative Dentistry and established

specialist trainers at Case Discussion Forum.

EvaluationFormative: Contribution at Case Discussion Forum [Weekly] Contribution at Current Literature Review groups [Monthly] Feedback from clinical trainers and patients [Sessional] Summary sheets on thematic literature [Termly]

Summative: Essays on thematic literature [Termly] Written documentation of treated cases [Annual] RITA [Annual] MRD


Advanced Clinical Prosthodontics

IntroductionThis module is based on developing the ability to diagnose, plan and execute prosthodontic treatment which is appropriate to the patient and to the constraints under which the clinician or patient may find him/herself. This module in conjunction with the generic module on Interdisciplinary Care, emphasises the importance of knowledge in the other disciplines which make up restorative dentistry The module highlights the need for every treatment plan to take into account possible future dental disease and the need to plan for mechanical failure. Experience is also gained of patients who require management by dental specialities outside restorative dentistry. The trainee(s) will share learning with trainees in the other Restorative monospecialities as well as with Specialist Registrars in Restorative Dentistry. This module will facilitate the documentation of cases required for the MRD exam.

AimsTo provide: The opportunity of attending inter-disciplinary treatment planning and review clinics in Restorative Dentistry and the

management of patients affected by hypodontia. The environment where treatment plans and the stages in execution of treatment can be discussed with other trainees,

technical staff and with established specialists. To provide the opportunity of being closely involved with the laboratory stages of treatment in order to fully appreciate

the importance of communication with the laboratory, and in having a thorough understanding of technical procedures. The opportunity to consider treatment plans in the light of published literature. The opportunity of treating patients who require combinations of fixed/removable/implant restorations. A forum for discussing the management of patients treated in the practice where the trainee is working part-time.

Learning OutcomesBy the end of the course the trainee will be expected to: Understand the role of inter-disciplinary teams in the management of selected patient groups. Fully appreciate the importance of taking into account disease susceptibility and modes of failure of restorations in

relation to treatment planning. Demonstrate the ability to tailor options to match patient expectations and technical and financial constraints. Be competent in planning and executing treatments involving combined fixed and removable Prosthodontics and in

formulating appropriate maintenance programmes. Be well versed in laboratory techniques and demonstrate effective communication with laboratory staff.

Assigned tasksClinical Attendance at designated inter-disciplinary Restorative and Hypodontia planning and review clinics. Personal clinical treatment of part-dentate patients who require combined fixed/removable Prosthodontics.






Maxillofacial Prosthodontics

IntroductionThis module is designed to provide the trainee with the knowledge and skills to diagnose and manage patients who require maxillofacial prosthodontic treatment, for existing or planned maxillofacial defects.

AimsTo provide: An understanding of the relevant craniofacial anatomy. A basic knowledge of the epidemiology and surgical interventions resulting in maxillofacial defects. An awareness of the anatomical defects and associated functional, phonetic and aesthetic problems that may be present

in an adult patient affected by congenital orofacial clefting. A knowledge of how radiotherapy and chemotherapy can result in altered anatomy and physiology impacting on

prosthodontic rehabilitation. An understanding of the behavioural science aspects of maxillofacial prosthetics. An acquaintance with materials used in the clinic and laboratory for the construction of maxillofacial prostheses. A working knowledge of the role of the prosthodontist in the multidisciplinary treatment planning, surgical stages and

prosthodontic rehabilitation of the patient undergoing maxillary or mandibular resection. An understanding of the effect of maxillofacial defects and prostheses on speech and swallowing function. An understanding of the role and limitations of using osseointegrated implants with maxillofacial prostheses. A basic knowledge of the materials used, methods available to retain, and limitations of extra-oral prostheses.

Learning OutcomesBy the end of the course the trainee will be expected to: Demonstrate an understanding of the aetiology, epidemiology, relevant anatomy and pathophysiology of maxillofacial

defects. Demonstrate the ability to formulate a treatment plan for a patient due to undergo maxillary or mandibular resection. Diagnose problems associated with an existing intra-oral prosthesis. Plan and carry out the treatment necessary to provide oral rehabilitation in a patient with an intra-oral maxillary or

mandibular defect. Demonstrate an understanding of the maintenance requirements of patients with intra-oral maxillofacial prostheses. Demonstrate an understanding of the role of osseointegrated implants in maxillofacial Prosthodontics. Have an understanding of the modifications and definitive prostheses used to improve speech and swallowing. Demonstrate an awareness of the design features and limitations of extra-oral prostheses.

Assigned tasksClinical Attendance at designated dental oncology support clinic. Personal clinical treatment of patients who require maxillofacial prostheses






Prosthodontic Technology

IntroductionCoherent treatment planning which involves the provision of laboratory made restorations and appliances requires that the clinician has a thorough understanding of the technical processes involved. The clinician must also have the skills to prepare diagnostic casts incorporating wax-up, tooth adjustment or tooth movement in preparation for pre-restorative orthodontic treatment. Central to both these issues is the ability to communicate effectively with dental technologists.

AimsTo provide: Opportunities and facilities for being closely involved with the diagnostic and production stages of treatment in order to

fully appreciate the importance of accurate, quality clinical records and communication with the laboratory. A thorough understanding of technical processes involved in the production of fixed and removable restorations.

Learning OutcomesBy the end of the course the trainee will be expected to: Be conversant with laboratory processes used to fabricate commonplace fixed and removable restorations. Be confident that the level of technical knowledge acquired would enable a mutually beneficial relationship to develop

with technical staff.

Assigned tasks Carry out the diagnostic work required in preparation for the MRD cases. Carry out the preparatory work for at least one case requiring pre-restorative orthodontic treatment. Be responsible for trimming dies in preparation for fixed restorations. Be responsible for preparing non-cast custom implant abutments where this stage is undertaken on the cast. Be responsible for preparing positional guide channels in radiographic and surgical implant templates. Attend a course (in-house) on TMD that involves the clinical and technical preparation of a hard acrylic stabilisation

appliance.

EvaluationFormative: Contribution at Case Discussion Forum [Weekly] Feedback from technical staff, clinical trainers and patients [Sessional]

Summative:

MRD


Generic Modules

The generic modules which follow are common to all monospeciality training programmes.

Interdisciplinary care

Management of the medically compromised patient

Evidence based dentistry

Management, team building and interpersonal skills

Clinical audit, quality assurance and clinical governance

The specialist practitioner and education

Specialist dental practice: management, ethics and medico-legal aspects

Revision for the MRDRCS examination


Inter-disciplinary Care

Introduction

This module is based on the importance of knowledge in the other disciplines that make up restorative dentistry in order to diagnose, treatment plan and execute treatment that is appropriate to the patient and to the constraints under which the clinician or patient may find him/herself. The module emphasises the need for every treatment plan to take into account possible future dental disease and the need to plan for mechanical failure. Experience is also gained of patients who require management by dental specialities outside restorative dentistry. The trainee(s) will share learning with trainees in the other Restorative monospecialities as well as with Restorative Specialist Registrars. This module will facilitate the documentation of cases required for the MRD exam.

Aims

To provide: The opportunity of attending inter-disciplinary treatment planning and review clinics in Restorative Dentistry. The environment where treatment plans and the stages in execution of treatment can be discussed with other trainees,

technical staff and with established specialists. To provide the opportunity of being closely involved with any laboratory stages of treatment in order to appreciate the

importance of communication with the laboratory.

Learning Outcomes

By the end of the course the trainee will be expected to: Understand the role of inter-disciplinary teams in the management of selected patient groups. Fully appreciate the importance of taking into account disease susceptibility and modes of failure in relation to

treatment planning.

Assigned tasks

Clinical Attendance at designated inter-disciplinary Restorative planning and review clinics.

Academic Presentation of cases for discussion with trainee colleagues from all specialities of Restorative Dentistry and established


Evaluation

Formative: Contribution at Case Discussion Forum [Weekly] Feedback from clinical trainers and patients [Sessional]

Summative: Written documentation of treated cases [Annual] RITA [Annual] MRD


The Medically Compromised Patient

Introduction

There are several medical conditions that can impact upon the delivery of dental care. Furthermore, increasing life expectancy will have a significant impact on the prevalence of medically compromised patients attending for routine dental care. Medical conditions and the accompanying drug treatment that have the potential to affect dental treatment include: valvular heart diseases, anticoagulant therapy, organ transplant patients, patients with impaired haemostasis, patients on long-term corticosteroids and those with primary immunosuppressive disorders.

Aims

To provide: An evidence-based review on the effect of various medical conditions on the delivery of dental care.

Learning Outcomes

On completion of this seminar, the trainee will have an understanding of: The need for chemoprophylaxis in patients at risk from dental procedure – induced bacteraemia; The management of patients on anticoagulant therapy and long-term corticosteroids; The oral and dental problems of solid organ transplant patients and their management; The oral and dental problems of patients with primary immunosuppression and management strategies for such patients.

Leader

Professor R A Seymour

Suggested readingSeymour R A, Lowry R, Whitworth J M, Martin M V. Infective endocarditis, dentistry and antibiotic prophylaxis: time for a rethink? Br Dent J 2000;189: 610-616.Seymour R A, Thomason J M, Ellis J S. Oral and dental problems in the organ transplant patients. Dental Update 1994 (June): 209-212.Thomason, J M, Girdler N M, Kendall-Taylor, P et al. An investigation in organ transplant patients undergoing gingival surgery. J Clin Periodontol 1999; 26: 577-582.


Evidence Based Learning

Introduction

As with medicine there is an increasing need to use evidence based on clinical trials and other scientific studies to influence current practice. This module will be incorporated as part of the thematic and current literature reviews in each Monospeciality. Trainees will be expected to consider the quality of the evidence base for clinical practice during each seminar. In addition they will be expected to choose one of their previous review areas and within that area consider evidence supporting clinical practice and the quality of such evidence. This exercise, which is scheduled for year three, will extend to trainees in the other Restorative Monospecialities as well as Restorative Specialist Registrars. Each trainee will make an assessed presentation at the end of year three lasting no more than 30 minutes. Trainees with a particular interest may wish to attend a specific course on EBD (e.g. Oxford University: http://www.conted.ox.ac.uk/health) but this is not a specific requirement. A mentor will be assigned to trainees so that they can discuss their EBD learning requirements on an individual basis.

Aims

To provide: An introduction to the concepts of EBD A familiar context to expound the concepts of EBD Experience in making a presentation An opportunity to communicate EBD between specialities

Learning Outcomes

By the end of the course the trainee will be expected to: Have accessed information on EBD (e.g. http://www.nature.com/ebd http://www.cche.net) Understand the terminology related to evidence based dentistry Know the merits and limitations of the various types of study Be familiar with the idea of using meta-analysis

Assigned tasks Identification of a suitable subject to make an evidence based presentation 30 minute presentation to trainers and other trainees

Evaluation

Formative: Feedback from trainees and trainers during literature review sessions [Sessional] Summary sheets on thematic literature [Termly]

Summative: Evaluation of quality of 30 minute presentation [end of year 3] MRD


http://www.cche.net/

http://www.nature.com/ebd

http://www.conted.ox.ac.uk/health

Management, Team Building and Interpersonal Skills

IntroductionIt is acknowledged that trainees will become team leaders in their chosen field. They will need generic skills in management, team building and interpersonal communication for effective and enjoyable working in both the Hospital and Specialist practice environments.

Aims

To provide: Opportunities for structured training in management skills including: time management, working in meetings, managing

a team, delegation, influencing, persuasion, negotiation and managing others. Delivered by professional management trainers from the region.

An understanding of the current structure and funding of the NHS A supportive environment for applying the skills learnt

Learning Outcomes

By the end of the course the trainee will be expected to: Understand basic management theory Have had opportunities of applying facets of management skill to their daily work Have had the opportunity of becoming involved with Monospeciality training course organisational issues where

appropriate

Assigned Tasks Attend appropriate management training courses.

Evaluation

Formative: Feedback from trainees, ancillary staff and trainers


Clinical Governance and Audit

Introduction

Across medicine and dentistry, there is an increasing emphasis on clinical governance and audit as tools to improve the quality of our practice and the service provided to patients. Trainee attendance at all Restorative clinical governance and audit meetings is mandatory from the start of the programme.

Trainees will be expected to consider the various aspects of governance (quality information, evidence based healthcare and clinical guidelines, clinical performance assessment and professional / managerial relationships) and audit and their relationship to clinical practice. In addition they will be expected to identify a topic for clinical audit, possibly associated with one of their previous review areas, to be carried out and reported on. Ideally, there should be a re-audit of the chosen topic to complete the audit cycle and determine if recommendations have been effective.

A mentor will be assigned to trainees so that they can discuss their clinical governance and audit learning requirements on an individual basis.

Aims

To provide: An introduction to the concepts of Clinical Governance and audit Experience in designing and carrying out a clinical audit project Experience in presenting the results of such a project Experience in completing the audit cycle and implementing change.

Learning Outcomes

By the end of the course the trainee will be expected to: Have accessed information on clinical governance and audit Understand the terminology related to clinical governance and audit Know the merits and limitations of the audit process Be familiar with the concepts of clinical governance

Assigned Tasks Identification of a suitable subject to audit (years 2 and 3) 30 minute presentation to trainers and other trainees / department clinical governance and audit meeting (year 3) re-audit (year 4)

Evaluation

Summative: Evaluation of quality of 30 minute presentation [year 3] MRD


The Specialist Practitioner and Education

Introduction

This module is designed to provide the required theoretical and practical opportunities for the understanding and practice of teaching, learning and presentation skills appropriate to the specialist practitioner.

Aims

To provide: To ensure that the trainee has a sound basis from which to approach the educational activities likely to form part of a

future specialist career.

Learning Outcomes

By the end of the course the trainee will be expected to: Understand the learning process and the limitations of educational formats including lectures, seminars, and practical

work. Have the ability to select appropriate techniques from a range of teaching, learning and assessment skills. Have experience of the process of peer review of teaching, and of effective methods for communicating feedback. Be confident in planning and delivery in the appropriate format. Become familiar with educational technologies currently available for teaching and learning in clinical dental subjects.

Assigned Tasks Attendance at courses delivered by educational specialists. Presentation at case discussion seminars Leading topic based MSc seminars (years 3 and 4) Delivery of lectures Delivery of post-graduate courses including hands-on elements

Evaluation

Formative: Contributie to the teaching facet of Case Discussion Forum [Weekly] Feedback from participants at assigned educational activities.


Specialist Dental Practice: Management, Ethics and Medico-legal Aspects

Introduction

Most monospeciality trainees enter training in order to pursue private specialist practice. Whilst the hospital is well equipped to provide didactic education and clinical experiences, exposure to specialist practice and practitioners is essential to ground trainees in the ethical, medicolegal and managerial issues of establishing and running a successful specialist practice. This module will allow trainees to visit specialist practices, to experience management systems and protocols, and to discuss the pitfalls and particular considerations of specialist private practice.

Aims

To provide: Opportunities for trainees to spend time in a number of private and specialist practices. Opportunities to witness systems for patient and business management, record keeping and relationships with referring

dentists in successful specialist practices. Opportunities to discuss emergent issues with experienced specialist practitioners.

Learning Outcomes

By the end of the course the trainee will be expected to: Understand the special issues in establishing a specialist referral practice. Understand the special ethical and medicolegal considerations in managing referred private patients. Have improved communication skills in correspondence with referring practitioners. Have improved business sense for running a successful private specialist practice.

Assigned Tasks Attend a number of private and specialist practices (years 3 and 4) Attend discussion/seminar groups with specialist practitioners. Incorporate elements of private patient management and developing relationships with referring practitioners during

hospital and practice-based clinical activity.

Evaluation

Formative: Feedback from practices visited. Contributions to discussion/seminar groups. Observation of hospital-based patient management, time management, correspondence with referring practitioners.


Preparation for the MRDRCS Examination (Prosthodontics)

Introduction

Scheduled sessions to ensure that trainees have adequate curriculum time for topic-based revision of subjects identified by themselves or by teachers.

Aims

To provide: The aim is to prepare for a success at the written and verbal parts of MRD examination and to ensure preparation of

appropriate presentation material.

Learning Outcomes

By the time of taking the MRD the trainee will be expected to: Have the ability to locate, recall and organise specialist knowledge included in the curriculum to provide

well-structured, coherent and focused answers to questions posed verbally or in writing. Have the skills required to analyse verbal and written questions and frame an argument that will address the elements of

the question in an efficient manner. To be able to effectively evaluate clinical data, casts, records, photographs, radiographs etc. of prosthodontic relevance

without preparation time.

Assigned Tasks Revision sessions in selected areas of the curriculum. Essay practise from past papers

Evaluation

Formative: Evaluation of performance at revision seminars.

Summative Results of essay practise from past papers.


Appendix 1

Aims and Learning Outcomes: Clinical Domain

General educational aim:

To provide opportunities for clinical practice of increasing complexity in a supportive environment; provide opportunities to master a full range of contemporary prosthodontic materials, methods and techniques; develop a spirit of constructive self criticism and an understanding of limits in the management of clinical cases. To communicate effectively with the dental laboratory. To highlight the deficiencies in current research base, and the need for ongoing investigation. To encourage the development of clinical academic inquiry.

On completion, the trainee should be able to demonstrate the following skills/knowledge: Ability to communicate verbally and in writing with colleagues and patients. Ability to integrate prosthodontic and other restorative management within the

context of total patient care. Refined skills in prosthodontic diagnosis, treatment, case review and after-care. Ability to critically self-appraise. Ability to evaluate innovations in practice and critically appraise the guidance of

dental manufacturers and retailers. Ability to keep clear, succinct records, and document cases for presentation

purposes. Understanding of special issues relevant to patient management in a specialist

practice which are developed further in the generic module: Specialist Dental Practice: Management, Ethics and Medico-legal Aspects.

The assigned tasks in achievement of these learning outcomes are:

Attendance at prescribed clinics and weekly Case Discussion Forum; effective management of clinical time; accurate documentation of cases; good clinical record keeping; verbal presentation of 4 cases (years 1 and 2), 1 full written case report (year 2), and 3 full written case reports each year (years 3 and 4).

Evaluation of the achievement of these learning outcomes will be realised by:

Formative: General feedback from clinical teachers and patients; contribution at weekly Case Discussion Forum. Feedback from treatment planning and progress discussions with educational supervisors/specialist trainers.

Summative: End of year documented clinical cases.


Appendix 2

Aims and Learning Outcomes: Academic Domain

General educational aim:To provide, in addition to the requirements of the MSc in Restorative Dentistry, core academic knowledge required for the safe and effective diagnosis, treatment, follow-up and prognostication for complex prosthodontic cases managed in specialist practice. To provide foundations for life-long learning and critical self-appraisal. To highlight the deficiencies in current research base, and the need for ongoing investigation. To encourage the development of academic inquiry.

On completion, the trainee should be able to demonstrate the following skills/knowledge:

Ability to assimilate and critically appraise clinical and scientific literature. Sound understanding of the prevention, diagnosis, clinical treatment and

evaluation of patients with prosthodontic problems/disorders. Sound understanding of materials science. Sound understanding of laboratory procedures. Ability to find reference information when needed. Ability to critically evaluate developments in materials, techniques and clinical

practice based on a sound knowledge of current scientific knowledge.

The assigned tasks in achievement of these learning outcomes are: Completion of MSc Completion of assigned thematic reading Preparation of summary sheets; Attendance and contribution at current literature review groups Termly thematic literature essays.


Formative: evidence of reading; participation in current literature review; summary sheets on thematic literature review.

Summative: MSc written papers, essays on thematic literature.


Appendix 3

Aims and Learning Outcomes: Research Domain

General educational aim:To provide, as part of the requirements of the MSc in Restorative Dentistry, experience in reviewing the literature, carrying out, analysis, writing up and reporting of a research project related to the Monospeciality area. Whilst most of this work will be carried out in years 1 and 2 trainees should expect to continue some research activity in years 3 and 4.

On completion, the trainee should be able to demonstrate the following skills/knowledge:

Ability to critically review scientific literature relevant to the proposed study.

Ability to formulate a hypothesis and devise methods of testing it

Ability to establish clear aims and objectives for a research project

Ability to work in a structured scientific manner, record findings systematically in a research log book and prepare a research manuscript

An understanding of statistics relevant to the research undertaken

Ability to analyse data and make valid conclusions

Ability to compare results with those of other workers

An appreciation of the clinical relevance and shortcomings of the work

The assigned tasks in achievement of these learning outcomes are: Completion of MSc literature review Completion of a contemporaneous laboratory log book Completion of one or more manuscripts for journal submission Presentation of research findings locally, nationally and, where appropriate,

internationally


Formative: MSc literature review criticised by internal examiners after one year

Presentation of research findings to faculty

Summative: MSc dissertation (including lab book, literature review and manuscript).

MSc dissertation viva

Journal reviewers’ reports


Appendix 4

Time commitment years 1 & 2– full time traineeThe tables below show the number of sessions and full-time student contact/preparation hours over the first and second years of the course including the MSc in Restorative Dentistry. (colour coding: Clinical, Academic, Research) .

Year 1No. of sessions

(A)

Mean sessionDuration (hrs)(B)

Student contact hours

Total (A) x (B)

Seminars

ConsEndoInterrelated subjectsMaterials SciencePhantom HeadPerioProstho

Total

1492519132110

1121.5 seminar1.5 preparation

168168

Phantom Head Practical 13 2 26

Lab Course 12 31 preparation

36 12

Clinic terms 2,3

ConsEndoPerioProstho

TotalCase presentation/waxing

20202020

8020

32

240 40

Statistics 13 1.5 19.5

Research ProjectLiterature reviewPracticalTutorials

203010

532

100 90 20

Combined practitionerCoursesOcclusion & restorationsTMDImplantSedationTotal

434213 3.5 45.5

Revision (Including essay practice)

50 3 150

Total contact hrs 1115



(A)



Total (A) x (B)

Review of Monospeciality

current literature10 1.5hr seminar

3 hrs preparation

15 30

Teaching experience20 3 60

Clinic terms 4,5,6

Monospeciality : Restorative 3:1

100 3 300

*Diagnostic Clinics40 3

120

Research ProjectPracticalTutorialsWriting-up

401520

825

320 30 100

Revision50 3 150


* spread flexibly between years 1 and 2(colour coding: Clinical, Academic, Research) .


Time commitment years 1 & 2 – part time traineeThe tables below show the number of sessions and part-time student contact/preparation hours over the first and second years of the course including the MSc in Restorative Dentistry (colour coding: Clinical, Academic, Research).


(A)



Total (A) x (B)

Seminars

ConsEndoInterrelated subjectsMaterials SciencePhantom HeadPerioProstho

Total

1492519132110

1121.5 seminar1.5 preparation

168 168

Phantom Head Practical 13 2 26

Lab Course 12 31 preparation

36 12

Clinic terms 2,3

ConsEndoPerioProstho

Total

Case presentation/waxing

20202020

8020

32

240 40

Statistics 13 1.5 19.5

Research ProjectLiterature reviewPracticalTutorials

203010

532

100 90 20

Combined practitionerCoursesOcclusion & restorationsTMDImplantSedation

Total

4342

13 3.5 45.5Revision (Including essay practice)

50 3 150




(A)



Total (A) x (B)

Review of Monospeciality

current literature10 1.5hr seminar

3 hrs preparation

15 30

Teaching experience

Clinic terms 4,5,6

Monospeciality : Restorative 3:1Practice caseCase presentation/waxing

801530

322

240 30 60

Diagnostic Clinics20 3

60

Research ProjectPracticalTutorialsWriting-up

401520

825

320 30 100

Revision50 3 150


(colour coding: Clinical, Academic, Research)


Analysis of years 1 & 2 and years 3 & 4 relative to 4500hrs

Full time specialist trainee4500hrs over 3y@ 60% clinical 25% academic 15% research

Years 1 & 2 (inc. 2 year MSc)

Years 3 & 4

ClinicalAcademicResearch

27001125 675

762 818 660

1938 307 15

Total 4500 2240 2260

Part time specialist trainee

4500hrs over 3y@ 60% clinical 25% academic 15% research

Years 1 & 2 (inc. 2 year MSc)

Years 3 & 4

ClinicalAcademicResearch

27001125 675

732 758 660

1968 367 15

Total 4500 2150 2350

NB 4500 hours is the minimum time a trainee would spend on the programme. The figures are not intended to be absolute but to give a guide to how the balance of time spent in clinical, academic and research activities changes between years 1-2 and years 3-4.

The research component is front loaded as an MSc requirement at the beginning of the course. Depending on the nature of the project more or less time may be spent during years 1-2. However, the trainee would be expected to submit at least one manuscript for scientific journal publication during years 3-4.


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