Ghotane S G, Harrison V, Radcliffe E, Jones E, Gallagher J E
King's College London Dental Institute at Guy's, King's College and St Thomas's Hospitals, Division of Population and Patient Health, Denmark Hill Campus, Bessemer Road, London, SE5 9RS.
King's College London DI.
Br Dent J. 2017 May 12;222(9):700-707. doi: 10.1038/sj.bdj.2017.404.
Background The need for periodontal management is great and increasing; thus, the oral and dental workforce should be suitably equipped to deliver contemporary care. Health Education London developed a training scheme to extend the skills of dentists and dental care professionals (DCPs).Aim To examine the feasibility of assessing a skill-mix initiative established to enhance skills in clinical periodontology involving the views of patients, clinicians and key stakeholders, together with clinical and patient outcomes in London.Methods This mixed methods feasibility and pilot study involved four parallel elements: a postal questionnaire survey of patients; analysis of clinical logbooks; self-completion questionnaire survey of clinicians; and semi-structured interviews of key stakeholders, including clinicians.Results Twelve of the 19 clinicians participated in the evaluation, returning completed questionnaires (63%) and providing access to log diaries and patients. Periodontal data from 42 log-diary cases (1,103 teeth) revealed significant improvement in clinical outcomes (P = 0.001 for all). Eighty-four percent (N = 99) of the 142 patients returning a questionnaire reported improved dental health; however, responses from hospital patients greatly exceeded those from dental practice. Interviews (N = 22) provided evidence that the programme contributed to professional healthcare across four key domains: 'service', 'quality care', 'professional' and 'educational'. Clinicians, while supportive of the concept, raised concerns regarding the mismatch of their expectations and its educational and service outcomes.Discussion The findings suggest that it is feasible to deliver and evaluate inter-professional extended skills training for dentists and dental care professionals, and this may be evaluated using mixed methods to examine outcomes including clinical log diaries, patient questionnaires and stakeholder interviews. This inter-professional course represents a positive development for patient care using the expertise of different members of the dental team; however, its formal integration to the health and educational sectors require further consideration.
牙周病管理的需求巨大且不断增加；因此，口腔和牙科从业人员应具备提供现代护理的适当能力。伦敦健康教育部门制定了一项培训计划，以扩展牙医和牙科护理专业人员（DCPs）的技能。
探讨评估一项旨在提高临床牙周病学技能的技能组合倡议的可行性，该倡议涉及患者、临床医生和关键利益相关者的意见，以及伦敦的临床和患者结果。
这项混合方法的可行性和试点研究包括四个并行要素：对患者进行邮政问卷调查；分析临床日志；对临床医生进行自我完成问卷调查；以及对包括临床医生在内的关键利益相关者进行半结构化访谈。
19名临床医生中有12名参与了评估，返回了完整的问卷（63%），并提供了日志和患者信息。来自42例日志病例（1103颗牙齿）的牙周数据显示临床结果有显著改善（所有P值均为0.001）。142名回复问卷的患者中有84%（N = 99）报告牙齿健康有所改善；然而，医院患者的回复大大超过了牙科诊所患者的回复。访谈（N = 22）提供了证据，表明该计划在四个关键领域对专业医疗保健做出了贡献：“服务”、“优质护理”、“专业”和“教育”。临床医生虽然支持这一概念，但对他们的期望与教育和服务结果之间的不匹配表示担忧。
研究结果表明，为牙医和牙科护理专业人员提供和评估跨专业扩展技能培训是可行的，并且可以使用混合方法进行评估，以检查包括临床日志、患者问卷和利益相关者访谈在内的结果。这一跨专业课程利用牙科团队不同成员的专业知识，对患者护理来说是一个积极的发展；然而，其与卫生和教育部门的正式整合需要进一步考虑。
