Unit information: Year 2 BDS in 2020/21

Unit name	Year 2 BDS
Unit code	ORDS20028
Credit points	120
Level of study	I/5
Teaching block(s)	Academic Year (weeks 1 - 52)
Unit director	Dr. Cunningham
Open unit status	Not open
Pre-requisites	Successful progression from Year 1 BDS.
Co-requisites	None
School/department	Bristol Dental School
Faculty	Faculty of Health Sciences

Description including Unit Aims

Year 2 develops Year 1 themes of Practitioner, Person and Citizen, Scientist and Scholar, and Professional and Agent of Change.

During Term 1, students work on clinic with BDS peers and BSc hygienist/therapists to develop their skills in history taking and examination, communication, preventive care, clinical periodontal procedures underpinned by application of knowledge of ethics, law and professionalism. Chairside assisting skills are also consolidated. Much of the Year 2 unit aims to develop students’ understanding of, and manual skills in, periodontology (Term 1) and operative restorative dentistry (Terms 1 and 2) through interprofessional learning with BSc students in the clinical skills laboratory. This is supported by parallel teaching in related subjects such as periodontal disease, tooth morphology, oral biology, and dental caries. Removable prosthodontics teaching in the laboratory also commences in Year 2.

Students develop Year 1 foundations of scientific heath and disease by studying patients’ medical conditions, particularly those likely to be encountered in adult clinics. Pharmacology is taught concurrently to maximise its relevance and support safe patient care. Students develop a wider appreciation of patients’ health and the importance of ‘whole person care’ through attendance at a disability awareness workshop. Case-based sessions aim to assimilate and consolidate learning, particularly its clinical relevance, using interactive peer discussion and presentation-based formative assessment. Students are taught radiography theory to IRMER requirements, learn to take radiographs, and interpret common dental pathology on radiographs.

Successful completion of ‘Gateway to First Patient Care’ assessments allows students to begin treating adult patients in Term 2. Students take patient histories, examine new patients, and provide periodontal and preventive care. They also learn how to administer local anaesthesia, supported by pharmacology teaching and revision of relevant oral anatomy. Following successful completion of the operative skills course in Term 3, students carry out first restorative procedures for patients.

Students further develop their early clinical and team-working skills by sharing patient care with senior BDS and BSc colleagues at a local outreach clinic. Students’ understanding of evidence-based practice also develops through a series of termly workshops. Year 2 retains a strong focus on student wellbeing and study skills, and students are encouraged to engage with Bristol Futures.

Unit Aims:

1. Continue to develop the student as an adult learner and inspire them in the study of dentistry
2. Encourage and enable students to apply underlying scientific principles to an understanding of human health, human diseases, and common dental diseases
3. Encourage students to view health, illness and health care within social, cultural and ethical contexts
4. Provide opportunities for students to commence the development of their practical skills in periodontal, operative, and removable prosthodontic procedures
5. Introduce students to the principles and practice of obtaining and recording a comprehensive patient assessment, to enable the synthesis of findings for clinical diagnosis, risk assessment and treatment planning
6. Ensure students have the required knowledge, skills and attributes to commence safe care for patients within the clinical environment
7. Provide opportunities for students to interact effectively and appropriately within the NHS healthcare environment and dental healthcare teams
8. Further develop training in communication skills and use of dental terminology
9. Further develop students’ professional behaviour and understanding of the duty of candour
10. Continue to support students in dealing with the complexity, uncertainty and change that is inherent in dental practice.

Intended Learning Outcomes

Year 2 continues the delivery of the GDC Preparing for Practice (2015) intended learning outcomes which commenced in Year 1. The majority continue into subsequent years of the programme. All ILOs will be met by end Year 5.

Knowledge and Understanding

OVERARCHING OUTCOME

1. Practise safely and effectively, making the high-quality long-term care of patients the first concern
2. Recognise the role and responsibility of being a registrant and demonstrate professionalism through their education, training and practice in accordance with GDC guidance
3. Recognise the importance of lifelong learning and apply it to practice

CLINICAL

1. Individual patient care - GDC ILO 1.1.5, 1.1.8, 1.1.10, 1.1.11, 1.1.12
2. Patient Management – GDC ILO 1.7.9, 1.7.10
3. Health promotion and disease prevention - GDC ILO 1.10.1
4. Hard and soft tissue disease - GDC ILO 1.12.1
5. Population-based health and care - GDC ILO 2.1

COMMUNICATION

1. Patients, their representatives and the public - GDC ILO 3.2
2. Ethical and legal - GDC ILO 7.4
3. Teamwork - GDC ILO 8.3

Intellectual skills and attributes

OVERARCHING OUTCOMES

1. Describe the principles of good research, how to access research and interpret it for use as part of an evidence-based approach to practice
2. Apply an evidence-based approach to learning, practice, clinical judgment and decision making and utilise critical thinking and problem-solving skills
3. Accurately assess their own capabilities and limitations, demonstrating reflective practice, in the interest of high-quality patient care and act within these boundaries

CLINICAL

1. Individual patient care - GDC ILO 1.1.1, 1.1.2

Other skills and attributes (practical/professional/transferable)

OVERARCHING OUTCOMES

1. Demonstrate effective clinical decision making

CLINICAL

1. Individual patient care - GDC ILO 1.1.3, 1.1.4, 1.1.6, 1.1.7, 1.1.9, 1.1.13
2. Comprehensive patient assessment - GDC ILO 1.2.1, 1.2.2, 1.2.3, 1.2.4, 1.2.5, 1.2.6, 1.2.7
3. Diagnosis - GDC ILO 1.4.1, 1.4.2
4. Treatment planning - GDC ILO 1.5.1, 1.5.2, 1.5.3, 1.5.4, 1.5.5, 1.5.6
5. Patient management - GDC ILO 1.7.1, 1.7.2, 1.7.3, 1.7.4, 1.7.5, 1.7.8, 1.7.11
6. Patient and public safety - GDC ILO 1.8.1, 1.8.2, 1.8.3, 1.8.4, 1.8.5, 1.8.6, 1.8.7
7. Treatment of acute oral conditions - GDC ILO 1.9.1, 1.9.2, 1.9.3, 1.9.4
8. Health promotion and disease prevention - GDC ILO 1.10.2, 1.10.3, 1.10.4, 1.10.5, 1.10.7
9. Management and treatment of periodontal disease - GDC ILO 1.11.1, 1.11.2, 1.11.3, 1.11.4, 1.11.6
10. Hard and soft tissue disease - GDC ILO 1.12.2, 1.12.3
11. Management of the developing and developed dentition – GDC ILO 1.13.1, 1.13.2, 1.13.3
12. Restoration and replacement of teeth - GDC ILO 1.14.1, 1.14.2, 1.14.3, 1.14.4, 1.14.5, 1.14.6
13. Population-based health and care - GDC ILO 2.2, 2.3, 2.4, 2.5

COMMUNICATION

1. Patients, their representatives and the public - GDC ILO 3.1, 3.3, 3.4
2. Team and the wider healthcare environment - GDC ILO 4.1, 4.2, 4.3, 4.4
3. Generic communication skills - GDC ILO 5.1, 5,2, 5.3, 5.4, 5.5

PROFESSIONALISM

1. Patients and the public - GDC ILO 6.2, 6.3, 6.4, 6.5
2. Ethical and legal - GDC ILO 7.1, 7.2, 7.3, 7.5
3. Teamwork - GDC ILO 8.1, 8.2
4. Development of self and others – GDC ILO 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7

MANAGEMENT AND LEADERSHIP

1. Managing self - GDC ILO 10.1, 10.2, 10.3, 10.4, 10.5, 10.6, 10.7, 10.8
2. Managing and working with others - GDC ILO 11.1, 11.2, 11.3, 11.4, 11.5, 11.6, 11.7, 11.8, 11.9
3. Managing the clinical and working environment - GDC ILO 12.1, 12.2, 12.3 12.5

Teaching Information

The teaching and learning methods in Year 2 reflect the aim of developing students as adult learners, whilst recognising that this takes time to develop. Students should be aware that approaches to teaching are designed to encourage the transition from undergraduate student to professional heath care practitioner. They should learn to study with the support of their peers, mentors and lecturers. All students will have access to dentists, scientists, researchers, allied health professionals and community health teams as appropriate. Year 2 will utilise a variety of teaching methods as listed below:

• Lecture-style content and use of the 'flipped' classroom
• Small group tutorial teaching / clinical communication sessions
• Peer group work, including case-based learning
• Private study time, supported by library and electronic learning
• Electronic learning packages
• Practical teaching: simulated clinical skills laboratories, biomedical sciences laboratories
• Clinical environments: peer learning, observations, chairside assisting, supervised dental treatment of patients

Teaching will use a blended learning approach delivered through a combination of synchronous and asynchronous activities. Students will be expected to engage with all learning. Clinical skills laboratory teaching will provide simulated 'phantom heads' and teeth for students to practice the necessary practical procedures to the required standard prior to patient care. These laboratory sessions will be supported by preparatory material, review of on-line Year 1 Biomaterial sciences teaching, viewing images/video clips and demonstrations, and regular formative assessment and feedback by supervising staff. Clinical sessions carrying out practical procedures with peers will take the same format as those in Year 1, including pre-session preparation, session briefing, closely supervised practice of key clinical procedures, reflection and peer/staff feedback. Students will be pre-allocated to act as patients for a variety of their peers during the course of these sessions. This teaching approach enables students to develop the necessary skills and attitudes required for treating the diverse range of patients that will be encountered during the programme and within the wider population. Using peers as patients effectively supports the development of practical and patient management skills required for the transition to first patient care, and is underpinned by a range of General Dental Council Learning Outcomes within the domains of clinical care, communication, professionalism, and management and leadership (see 'Intended Learning Outcomes' above). Procedures where students will be required to act as patients include: history taking, examination of the head and neck, examination of the oral cavity (including the charting of teeth and periodontium), recording plaque indices, oral health advice, removal of dental deposits (as appropriate), suction practice, impression taking, and the delivery of local anaesthesia. This teaching approach will be fully supported by a process of informed consent, and an appropriate level of supervision by clinical teaching staff. Professional actors will act as patients in small group sessions for clinical communication and ethics, law & professionalism teaching. Clinical observation and assisting opportunities will continue in Year 2, with opportunities for integration between Y2 BDS21 and senior BSc H&T students. This will enhance teamworking and provide teaching and leadership opportunities for students. Case-based sessions in Terms 1 and 2 will integrate key concepts and reinforce links between clinical dentistry and scientific basis of dentistry topics. A disability awareness workshop will help to build students' understanding of the relevance of patients' medical conditions and their 'whole person care' needs.

Assessment Information

Summative assessment

An integrated, programmatic assessment comprising three parts delivered at the end of Year 2, covering a wide range of ILOs across themes. The End of Year 2 Summative Assessments will be taken as a first attempt in May/June and, if required, as a second attempt (resit) in July.

• Part 1) 2-hour Multiple Short Answer (MSA); 10 x 10-mark questions, each with equal weighting. Contributes 30% of the total Unit mark
• Part 2) 2-hour Single Best Answer (SBA) e-Assessment; 120 questions each with equal weighting. Contributes 30% of the total Unit mark

Students will be required to achieve a minimum aggregate score of 50% between Parts 1 and 2 in order to pass the Unit. Compensation will be allowed between Parts 1 and 2, providing a minimum score of 45% in either Part is achieved.

• Part 3) 2-hour Objective Structured Clinical Examination (OSCE); 16 x 5-minute stations (with 1.5-minute reading time). Contributes 40% of the total Unit mark. Students will be required to achieve a minimum score of 50% and have passed two thirds of the OSCE stations for Part 3 in order to pass the Unit.

Formative assessments & engagement milestones

• Attendance at compulsory teaching sessions
• Tooth morphology spotter
• Engagement with and progress in clinical communication workshops
• Engagement with Trust induction and Basic Life Support eLearning
• History & Examination formative assessment
• Gateway to first patient care assessments: knowledge e-Assessment, periodontology practical, clinical competencies
• Attendance at 'Transition to Patient Care' Ceremony
• Gateway to restorative patient assessments in clinical skills laboratory
• Completion of clinical e-Portfolio self-reflection accounts and evidence of satisfactory clinical progress by supervisors
• Completion of Year 2 PDP portfolio entries, including meetings with personal tutor & study skills development
• Radiography e-Assessment

Consequences of non-engagement with the engagement milestones may result in students not being permitted to take the End of Year 2 summative assessments and therefore will not be able to progress to Year 3.

Reading and References

Scrambler, SJ, Scott, S, Asimakopoulou, K. Sociology and psychology for the dental team: an introduction to key topics. 2016. Polity. ISBN 9780745654331

Moss, B. Communication skills in health and social care. 4^th Edition; 2017. SAGE Publications. ISBN 9781526401335

BDA Clinical Guide Series: A Clinical Guide to Oral Diagnosis and Treatment Planning

Newsome P, Smales R, Yip K; Oral Diagnosis and Treatment Planning: part 1. Introduction. BDJ 2012; 213: 15-19

FGDP Openstandards (https://www.fgdp.org.uk/guidance-standards/clinical-examination-and-record-keeping-0)

Eaton, K. and Ower, P. Practical Periodontics 1^st Edition; 2015. Churchill Livingstone. ISBN 9780702043574

BSP Implementing the 2017 classification of periodontal diseases to reach a diagnosis in clinical practice. (https://www.bsperio.org.uk/publications/downloads/111_153050_bsp-flowchart-implementing-the-2017-classification.pdf)

BSP The good practitioner’s guide to Periodontology (https://www.bsperio.org.uk/publications/good_practitioners_guide_2016.pdf?v=3)

Banerjee, A, Watson, TF. Pickard’s guide to minimally invasive dentistry. 2015 Oxford University Press.

Jacobsen, PH. Restorative Dentistry: an integrated approach. 2^nd edition: 2008. Blackwell Publishing.

Kidd, EAM, Fejerskov, O. Essentials of dental caries. 4^th Edition; 2016. Oxford University Press. ISBN

McCabe, JF, Walls, AWG. Applied dental materials. 9^th Edition; 2008. Blackwell Science. ISBN 9781405139618

Davenport, J.C. A clinical guide to removable partial dentures: the assessment and treatment of patients requiring RPDs. 2^nd Edition; 2000. British Dental Association. ISBN 9780904588590

Meechan JG, Robb ND, Seymour RA. Pain and Anxiety Control for the Conscious Dental patient. Oxford: Oxford University Press 1998. ISBN 0-19-262848-8

Whaites, E, Drage, N. Essentials of dental radiography and radiology. 5^th Edition; 2013. Churchill Livingstone. ISBN 9780702045998

Berkovitz, BKB, Holland, GR, Moxham, BJ, Makdissi, J. Oral anatomy, histology and embryology. 5^th Edition; 2018. Elsevier. ISBN 9780723438120

Lamont, RJ, Jenkinson, HF. Oral microbiology at a glance. 2010. Wiley-Blackwell. ISBN 9780813828923

Murray P, Rosenthal K, Pfaller M. 8th ed. Medical microbiology. Elsevier Saunders: 2015. ISBN: 9780323299565

Goering, RV, Mims, CA. Mims’ medical microbiology. 5^th Edition; 2013. Elsevier/Saunders. ISBN 9780723436010

Rang, HP, Ritter, JM, Flower, RJ, Henderson, G, Dale, MM. Rang & Dale’s Pharmacology. 8^th Edition; 2015. Elsevier Churchill Livingstone. ISBN 9780702053627

Neal, MJ. Medical pharmacology at a glance. 8^th Edition; 2016. Wiley Blackwell. ISBN 9781118902400