Literature Review: Transition from New Dental Graduates to Practice

This literature review examines the multifaceted transition process for new dental graduates moving into independent practice. It begins by defining transition and exploring strategies for a smooth integration, including undergraduate program regulations and vocational dental training (VDT). The review delves into factors influencing this transition, such as bringing in associates, selling practices, long-term partnerships, and competitor buyouts. A significant portion is dedicated to analyzing the undergraduate dental curriculum in the UK, including GDC recommendations and the evolution of VT. Furthermore, the review assesses the outcomes of a healthy transition, focusing on competency in dentistry, adherence to GDC standards, and the importance of lifelong learning and evidence-based practices. It also addresses the role of self-efficacy in dental practice and concludes by identifying existing gaps, justifying the need for further research in this area. Desklib is the perfect platform to access this document and other solved assignments.

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Literature Review: Transition in dentistry from New Graduates to Independent Practice
Name
Institution

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Table of Contents
Introduction ..................................................................................................................................... 4
Transition on Process of new Dentists ............................................................................................ 5
What is transition? ....................................................................................................................... 5
Strategies for a Smooth Transition Process ................................................................................ 5
Undergraduate program regulations ........................................................................................ 5
Vocational Dental Training (VDT) ......................................................................................... 6
Bringing in an associate ........................................................................................................... 6
Sell off a second practice ......................................................................................................... 7
Long-term partnership ............................................................................................................. 7
Buy out a competitor ............................................................................................................... 7
Slow down merger ................................................................................................................... 8
Curriculum .................................................................................................................................. 8
Features of the Dental Curriculum ........................................................................................ 11
Components of the curriculum .............................................................................................. 12
Curriculum development ........................................................................................................... 14
Curriculum Assessment............................................................................................................. 16
GDC Recommendations on the Dental Curriculum ..................................................................... 17
Dental Vocational Training........................................................................................................... 18
Background history ................................................................................................................... 18

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Where we are now ..................................................................................................................... 19
The selection and role of the trainers ........................................................................................ 23
Selection of Trainers .............................................................................................................. 23
Roles of Trainers ................................................................................................................... 23
Professional Development Portfolio ......................................................................................... 24
Vocational training in other countries ....................................................................................... 25
The Outcome of a Healthy Transition .......................................................................................... 27
Competency in Dentistry ........................................................................................................... 27
Standards for the dental team- General Dental Team 2013 ...................................................... 29
Lifelong leaner a key competency in Dentistry ............................................................................ 32
Evidence-Based Practices Journey ............................................................................................... 37
Clinical practical Guidelines and the use of Evidence-Based Practice (EBP) .......................... 39
Self- efficacy ............................................................................................................................. 41
References ..................................................................................................................................... 45

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Introduction
This chapter of the paper focuses on the relevant literature on different facets of transition in
dentistry from new graduates to independent practice. The first section of the literature review
focuses on the transition process for dentistry. It focuses on the definition of transition and
effective strategies to support a smooth transition process for new dentists. In this section,
undergraduate program regulations and vocational dental training as detailed. The section also
evaluate on the factors influencing the transition process as well as the outcome of a healthy
transition process. The section thus examines the criteria for assessment of competence,
competence versus self-efficacy, and the evidence-based protection and compliance in the
transition process.
The second section will focus on a detailed analysis of the undergraduate curriculum and its
development for dental schools in the United Kingdoms. It also covers the GDC
recommendations for the current dental school curriculum. This section also covers the VT
training with aspects such as the history of VT till the time is was considered compulsory in
1993. It evaluates the difference in the VT between Wales, Scotland, and England.
The third section is aimed at examining the outcomes of a health process of transition with the
aspect of a competent dentist and self-efficacy aspects of dentistry for undergraduates. It
examines the meaning of competency in the dentistry industry, the recommended GDC
requirements for competent dentists in their practice preparation process, and the relevant
competency aspects for dentists such as life-long learner and self-efficiency. The section also
examines the meaning of evidence-based practice and the relevant ethical guidelines in relation
to the clinical practice. The paper then summarizes by pointing out the existing gaps to prove the
need for study, an aspect that resulted into the research topic for this study.

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Transition on Process of new Dentists
What is transition?
Transition is the process of changing from one form state to another [1]. Gordon et al. defined
general transition in healthcare as a continuing process of shifting from one context and set of
interpersonal relationships to another, accompanied with variations in identities [2]. Getting
prepared for these transitions becomes complex when in the process, changes in role and
seniority leads to professional identity crisis. JindalSnape has given a more detailed definitions
which seems to fit well with the transition process as; a continuous process of psychological,
social and educational adaptation, happening over time due to variations in context, interpersonal
relationships and identity which can be both exciting and worrying and requires continuous
support.
The transition to general practice is a vital period in a new dentists‘ career since the new
graduates begin adjusting from working under supervision to becoming an independent medic
[3]. During this time, they enhance their competence and confidence. Though this move can be a
rewarding experience, it is also recognized as a daunting phase for new graduates. Various
approaches have been taken in an effort to facilitate a smooth integration into professional
practice.
Strategies for a Smooth Transition Process
Undergraduate program regulations
Transition is a slow continuous process, which is key in developing future dentists‘ identity, skill
and knowledge [4]. Clinical experiences, as an undergraduate, therefore, impacts on the
transition into practice. Since 1997, the GDC has specified the undergraduate curricular

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requirements to ease the transition process. Dental schools in the UK ought to follow
‗preparedness for practice‘ which provides a framework around which they can structure their
undergraduate curricular, so that all dental graduates can start their careers on the same level.
Vocational Dental Training (VDT)
Early exposure in general practice can influence the road a career treads upon [3]. Since 1993
dentists graduating from UK dental schools are supposed to undertake Vocational Training in
England (Foundation Training in England and Wales) as set out in The National Health Service
(Performers Lists). Therefore, the newly qualified dentists undertake a one year VDT as a
Vocational Dentist Practitioner (VDP) supervised by a vocational trainer. VDT advisors handle
schemes of 12 practices and organize 30 study days, as put into practice by the General Dental
Council. It provides a supportive learning environment with regular feedbacks from mentors
hence being core in a newly graduated dentist‘s clinical knowledge and competency
development.
Bringing in an associate
There is a cascade in the figures of dentists delineating that they have unsurpassed out their
fecund capacity and are not able to meet the ever increasing demand for their services. Raising
emolument, relocating to a new space, ameliorate scheduling, and enlarge operatory capacity are
guidelines that can be followed to handle this issue [4]. If these do not solve the problem, one
should consider getting an associate to help with the ever increasing patient demand. Although
associate alliances often yield a little profit during the momentary period, it is likely to have
alleviated profits in abiding alliances. To make maximum profits from this alliance, one needs to
keep total ownership for as long as possible. Therefore, dentists should get partners working on

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part time basis including doctors who have retired or fulltime partners who are not interested in
ownership. Occasionally dentists increase the volume of practice by 50%-100% during a 2-5
correspondence by having partners look into hygiene and do minor procedures. Rarely do
partners create more time for the top dentist [5].
Sell off a second practice
Dentists who wish to achieve career growth in their profession have a number of practice-
transition considerations to look into before they perfidy entirely. I have heard a cases of quite a
number of successful dentists give away a second practice spot so as to perceive its real
incorporeal worth [4]. In one particular situation, the dentist selling solely concentered her
energy on her prevailing practice spot and constructed it back to the creation and gathering
extents previously attained by both the practices in a time frame of less than two years. This
dentist then put her after-tax proceeds from the sale to come up with a second retirement kitty to
guarantee her pecuniary solidness, while her yearly earning cascade was not affected be selling
the second spot.
Long-term partnership
Dentists ought not to decline opportunities that appear to have lucrative potential for practice-
growth. It is because they have spotted an extraordinary partner whose desire is to be in a
situation with a potential for long-term ownership [4]. In most cases, the potential increase in
yearly profits and future equality in practice can make adding in an associate a situation of win-
win. In bigger practices, vending off a fraction of the interest in the practice to more than one
buyer could be the only means to get paramount advantage for the practice.
Buy out a competitor

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Dentists considering to increase volume of practice mostly take an inappropriate approach.
Registering to take part in a managed-care scheme with median fee concession of between 20%
to 30% is the most expensive approach. Buying another competitor‘s practice and incorporating
it into the existing dentist‘s office spot is the easiest and cheapest approach [6]. The fact that
fixed aloft costs including paraphernalia and space are already covered, imperceptible aloft such
as laboratory supplies and gradational labor on supplementary volume procured often goes to
only 30% to 40% of the secondary volume procured, adding up to 60% to 70% to the final figure
as auxiliary profit before servicing the debt. These would probably make the purchasing dentist
earn a total net profit of 45% to 60% after servicing the debt.
Slow down merger
Assuming several dentists are nearing the age of retirement, the dentists ought to look into
merging their practice, or sharing space in one spot [6]. In a particular situation two dentists who
were competing with one another desired to minimize clinical practice commitment to fewer
days a week. They came into agreement to merge their practices into a unit spot and run a 2 1/2
days every week or 5 days totally. They reached their targets of noticeably minimizing their
clinical load of work and availing for more off time from work.
Curriculum
A curriculum is one of the major aspects of every learning and educational fields. Shankar and
Dakubo defines Curriculum as to the total guided and well-designed learning process and
experience that enables the students to gain the knowledge in particular aspects and also enables
the teachers to use their professional judgment to determine the ability of the students after the
dissemination of the information [7]. The word curriculum is derived from the Latin word

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―currere‖ that means ‗to run‘, implying all the functions that are designed for a particular
learning process to take place.
Every learning based institution has a different well-designed curriculum that guides both the
students and the teachers in achieving the objectives. The curriculum covers both the theoretical
and the clinical aspects if the dentistry to provide an effective teaching method that moves the
dentistry students higher up the critical matrix of education. Therefore, under different
categories, the curriculum can be perceived as a set of objectives, a plan, and a document or as
experiences [8, 9]. Curriculum as set objectives means that every specific education institution
set educational and learning objectives that have to be achieved by every learner. This type of
curriculum is focused on the outcome and is always teacher oriented or administrative oriented.
The curriculum as a course is understood as the process of selecting a particular course or
content [10]. The use of the content and objective curriculum might be seen as same, however,
the objective curriculum focuses on the outcomes while the content curriculum focuses on the
instructional objectives. The curriculum as a plan is perceived as a systematic way of
implementing particular educational activities through a combination of various methods such as
content and objectives to provide a broader scope [11]. Curriculum as documents is perceived as
an outline of a course program that is drafted on a piece of paper. This particular curriculum is
associated with an official written program of study by relevant departments and educational
sectors. The document always covers statement of objectives, content, methods of
implementation and the assessment criteria and must always be followed systematically by the
teachers [12]. Lastly, curriculum as experience is perceived as the unplanned experience that is
completed by the student during the planned educational activities. All the experiences that a
leader is engaged to both inside and outside the classroom such as assemblies, school clubs,

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fetes, and academic competitions always facilitate the understanding of the subject under
discussion.
To ascertain the student's capability during the education period, the undergraduate dentistry
curriculum covers is categorized under two major categories: the first year and the upper-level
curriculum. In both the categories, there are various key areas that require students to cover in
both the academic and the clinical work: generic competence, centriole systems, skeletal
structures, the oral mucosa, disorders of the face and jaws, salivary glands diseases and pain
from the non-odontogenic origin.
Steven et al., denotes that the major aim of the undergraduate dental education is to produce a
caring, knowledgeable, competent and skillful dentist that upon graduation is able to show
professional responsibility on the patents' safety and experiences [13]. The undergraduate dental
curriculum thus must encourage recognition and acceptance of the dental obligations that are in
the best interests of the patients at all times [14]. The curriculum also requires that all the
undergraduate students to acquire and understand the clinical practice, skills and professional
attitudes that will promote effective lifelong learning and professional development. Basically,
the dental curriculum is designed to bring out three major issues on the students: Knowledge and
understanding, skills and attitudes.
The undergraduate student is required to know and understand the scientific basis of dentistry
such as the biomedical sciences, scientific methods, and evaluation. The undergraduate student is
required to obtain relevant skill such as the capability to undertake a range of wide clinical
procedures that will treat, prevent all the oral diseases, and also apply evidence-based practices.

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Lastly, the undergraduate student is required to obtain the attitudes such as the desire for
intellectual rigor, self-audit, and ability to participate in peer review [815].
Features of the Dental Curriculum
The selection of dental students is a critical aspect for the UK universities, thus a high level of
academic achievements on various subjects such as biological and physical sciences are key
entry points. Other subjects include literacy, numeracy and the ability to communicate. Dental
education tends to be more demanding than secondary schooling since particular health problems
are also considered [16]. The Health guidelines require that all the dental students go
immunization process to protect patients from blood-borne diseases before commencing the
educational program. Additionally, students are admitted only if they are physically able to
perform all the assigned tasks without strain and if this is in doubt, the students will further
undergo an individual assessment through clinical skills laboratory. Length of the dental program
Bourgeois et al. denotes that the UK dental university education covers a minimum of five
academic years of which at least eight terms of the period are spent by the student in the
university to study on the relevant courses [16]. The remaining period of the year is always
spent away in any other dental schools approved by the University Court and Senates Academics
for the completion of the education. During the five years, students should have passed through
full-time study at the dental medical schools or recognized medical institution to entry into the
dentistry association.

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Components of the curriculum
The dental curriculum is majorly subdivided into three major components that have to
sequentially teach over the first five years of undergraduate education. Al Sweleh et al. notes
three major components of the curriculum are:
 Biomedical subjects and any related dentistry topics; the learning progresses from the
molecular, cell biology, pathology, microbiology, anatomy biochemistry to the whole
body [17]. The intention of these components is to provide an appreciation of normal
human development structure, function, and socialization, behavior leading to a full
understanding of the causes, prevention, and treatment, diagnosis of the dental diseases.
 The oral and dental aspects of the biological sciences provide detailed knowledge of the
oral and dental issues: these leads to a progressive understanding of the diagnosis, causes,
treatment, and prevention of dental diseases.
 The clinical and technical aspects of dentistry aim at preparing the dental students with a
comprehensive oral and health care for all the patients of all ages [18]. The components
enable the students to be fully aware of the importance of the preventive methods and
treatment, thus students become aware of the compromised patients and how to deal with
each patient to bring out best experience.
The dental courses are subdivided into different depending on the level of the educational level
within the university:
 For the first years, courses such as the Bio-molecular Sciences, Anatomy, Physiology,
Biostatistics, Introduction to Dentistry, Oral Health and First aids, and Tooth Morphology
forms the major learning outlines [18]. The courses help the students to work on the