Ahluwalia Aneeta, Crossman Tim, Smith Helen
Division of Primary Care and Public Health, Brighton and Sussex Medical School, Room 321 Mayfield House, Village Way, Brighton, BN1 9PH, UK.
BMC Med Educ. 2016 May 11;16:142. doi: 10.1186/s12909-016-0663-8.
In the UK the incidence of oral cancers has risen by a third in the last decade, and there have been minimal improvements in survival rates. Moreover, a significant proportion of the population no longer access dental health services regularly, instead presenting their oral health concerns to their General Medical Practitioner. Therefore, General Practitioners (GP) have an important role in the diagnosis of oral health pathologies and the earlier detection of oral cancers. This study aims to understand the current provision of training in oral health and cancer for GP trainees and to identify how unmet training needs could be met.
A cross-sectional survey of GP Training Programme Directors using an online questionnaire asking about current oral health education training (hospital placements and structured teaching), the competencies covered with trainees and ways to improve oral health training. Quantitative data were analysed using descriptive statistics and content analysis was undertaken of free text responses.
We obtained responses from 132 GP Training Programme Directors (GPTPDs), from 13 of the 16 UK medical deaneries surveyed. The majority of respondents (71.2%) indicated that their programmes did not provide any structured oral health training to GP trainees and that ≤ 10% of their trainees were undertaking hospital posts relevant to oral health. GPTPDs were of the view that the quality of oral health training was poor, relative to the specified competencies, and that teaching on clinical presentations of 'normal' oral anatomy was particularly poor. It was envisaged that oral health training could be improved by access to specialist tutors, e-learning programmes and problem-based-learning sessions. Respondents highlighted the need for training sessions to be relevant to GPs. Barriers to improving training in oral health were time constraints, competing priorities and reluctance to taking on the workload of dentists.
This UK-wide survey has identified important gaps in the training of GP trainees in relation to oral health care and cancer detection. Addressing these knowledge and skill gaps, particularly in the identification of oral cancers, will help to improve oral health and, more importantly, the timely diagnosis of oral cancer.
在英国,口腔癌的发病率在过去十年中上升了三分之一,而生存率几乎没有提高。此外,相当一部分人口不再定期接受牙科保健服务,而是向他们的全科医生提出口腔健康问题。因此,全科医生在口腔健康病理诊断和口腔癌的早期检测中发挥着重要作用。本研究旨在了解目前针对全科医生培训学员的口腔健康和癌症培训情况,并确定如何满足未得到满足的培训需求。
通过在线问卷对全科医生培训项目主任进行横断面调查,询问当前的口腔健康教育培训(医院实习和结构化教学)、涵盖学员的能力以及改善口腔健康培训的方法。使用描述性统计分析定量数据,并对自由文本回复进行内容分析。
我们从接受调查的16个英国医学系中的13个系的132名全科医生培训项目主任(GPTPD)那里获得了回复。大多数受访者(71.2%)表示,他们的项目没有为全科医生培训学员提供任何结构化的口腔健康培训,并且他们的学员中≤10%正在从事与口腔健康相关的医院岗位工作。GPTPD认为,相对于规定的能力而言,口腔健康培训的质量较差,关于“正常”口腔解剖临床症状的教学尤其差。预计通过获得专科导师、电子学习项目和基于问题的学习课程,可以改善口腔健康培训。受访者强调培训课程需要与全科医生相关。改善口腔健康培训的障碍包括时间限制、相互竞争的优先事项以及不愿承担牙医的工作量。
这项全英国范围的调查发现,在全科医生培训学员的口腔保健和癌症检测培训方面存在重要差距。解决这些知识和技能差距,特别是在口腔癌识别方面的差距,将有助于改善口腔健康,更重要的是,有助于及时诊断口腔癌。