School of Dentistry, College of Biomedical & Life Sciences, Cardiff University, Heath Park, CF14 4XY, Cardiff, UK.
School of Dentistry, University of Dundee, Park Place, DD1 4HR, Dundee, UK.
BMC Med Educ. 2024 Feb 26;24(1):195. doi: 10.1186/s12909-024-05182-y.
This longitudinal study using qualitative methodology aims to investigate the perceptions, and implementation, of evidence-based guidelines into practice among new dental graduates (NDGs) during their transition from university into professional practice, by identifying factors that influence the adoption of evidence-based practice (EBP) in dental practice.
The study invited NDGs from one UK dental school (N = 66) and employed longitudinal, multiple qualitative methodologies for data collection, throughout the participants' Vocational Dental Training (VDT) year. Initial interviews (Interview 1) conducted upon graduation and follow-up interviews (Interview 2) carried out between six and nine months into professional practice were combined with participants longitudinal audio diaries (LADs) recorded between the interviews.
A total of 12 NDGs agreed to participate. For Interview 1, twelve participants were interviewed, seven of whom agreed to participate in Interview 2 and six recorded the LADs. Interview 1 exposed diverse views among NDGs about EBP, acknowledging its significance but facing obstacles in implementation due to time and financial constraints. They intended to use evidence selectively, often aligning with trainers' or NHS treatment options, while hesitating to fully embrace EBP in a busy dental practice. During VDT, LAD entries showed initial enthusiasm for EBP, but integrating evidence-based guidelines within the NHS system led to pragmatic treatment decisions, balancing gold-standard and cost-effective options. Over time, NDGs became more comfortable with alternative treatments, considering patients' financial constraints, yet they expressed frustration with external pressures limiting their clinical decision-making autonomy. In Interview 2, after six to nine months in practice, NDGs exhibited mixed attitudes towards EBP. Some actively used dental guidelines like SDCEP, others associated EBP with hi-tech or expensive materials, while others would thought to rely on colleagues' recommendations. None consistently sought direct evidence for treatment decisions.
NDGs' attitudes towards EBP changed and became more negative over their first year in professional practice, leading to challenges in their applying it. It questions the assumption that teaching EBP during undergraduate education ensures its implementation. Further understanding the influences on the development of attitudinal challenges will help to devise effective strategies for fostering lifelong learning and supporting evidence-based practice in dentistry.
本纵向研究采用定性方法，旨在通过确定影响牙科实践中采用循证实践（EBP）的因素，调查新牙科毕业生（NDG）从大学过渡到专业实践期间对循证指南的看法和实施情况。
该研究邀请了来自英国一所牙科学校的 NDG（N=66），并在参与者的职业牙科培训（VDT）期间采用纵向、多种定性方法进行数据收集。在毕业后进行的初始访谈（访谈 1）和专业实践六个月至九个月进行的后续访谈（访谈 2）与参与者的纵向音频日记（LAD）相结合，这些日记是在访谈之间记录的。
共有 12 名 NDG 同意参与。对于访谈 1，对 12 名参与者进行了访谈，其中 7 名同意参加访谈 2，6 名参与者记录了 LAD。访谈 1 揭示了 NDG 对 EBP 的不同看法，他们承认其重要性，但由于时间和财务限制，在实施方面面临障碍。他们打算有选择地使用证据，通常与培训师或 NHS 的治疗选择一致，同时在繁忙的牙科实践中犹豫不决地全面采用 EBP。在 VDT 期间，LAD 条目的最初内容显示出对 EBP 的热情，但将基于证据的指南整合到 NHS 系统中导致了务实的治疗决策，平衡了黄金标准和具有成本效益的选择。随着时间的推移，NDG 对替代治疗方法变得更加舒适，考虑到患者的财务限制，但他们对限制其临床决策自主权的外部压力表示沮丧。在访谈 2 中，在实践中六个月至九个月后，NDG 对 EBP 的态度表现出混合态度。一些人积极使用牙科指南，如 SDCEP，其他人将 EBP 与高科技或昂贵的材料联系起来，而其他人则认为依赖同事的建议。没有人始终为治疗决策寻求直接证据。
NDG 在专业实践的第一年中，他们对 EBP 的态度发生了变化，变得更加消极，从而对他们的应用提出了挑战。这对在本科教育阶段教授 EBP 以确保其实施的假设提出了质疑。进一步了解影响态度挑战发展的因素，将有助于制定有效的策略，以促进终身学习和支持牙科领域的循证实践。
