How to work alongside and not on top of participating practices…

31 March, 2015 / dcp-focus
 Bruce Oxley    Mike Wilkinson

A team of dental nurses and hygienist/therapists at the University of Dundee are working to change the face of modern dental research by keeping the patient at the heart of everything they do.

Based at the Dental Health Services Research Unit (DHSRU), the team have become an integral part of several major dental research trials that are currently being carried out across the UK.

Hygienist/therapist Laura Lovelock along with clinical dental research nurses Jill Gouick, Fiona Mitchell and Fiona Ord are involved with recruitment, collection of information and follow-up for trials such as IQuaD, INTERVAL, HOPSCOTCH and EDOCALD (for info, visit bit.ly/DHSRU).

Everyone has a voice whether you are a health economist, researcher or investigator

Marilyn Laird

Essential team members

“I wouldn’t consider doing a trial without the team. Absolutely not,” says Professor Jan Clarkson, co-director of DHSRU and director of the Effective Dental Practice Programme at the University of Dundee.

She explained that their input and interaction with patients and participating practices has changed the way DHSRU conducts research.

She said: “Over the years we have designed trials differently. Initially, we were expecting the dentist and the practice team to do all of the paperwork and the consenting. That is a very different job from the one they do on a day-to-day basis.

“Now the research teams go out to practices and they know exactly what to do and how to get patients on board. They can be in and out, almost without the practice being disturbed, they are amazing.

“They get to know the dental practices and the teams there. They are also effectively available to offer constant support for the practices.”

This new approach has started to bring very real benefits to the trials they are involved with. Prof Clarkson continued: “For IQuaD there were more than 2,000 participants who were assessed as being eligible and invited to take part, and only 150 said no. That is phenomenal.

“In medicine, recruitment to trials is the hardest thing to do.”

As well as recruitment, the research team travel the length and breadth of the UK, from the Highlands and Islands of Scotland to practices in Northern Ireland, the north of England, Birmingham, London and Wales. They also have input from the very start of trials.

Prof Clarkson said: “We would be absolutely lost without them. They are an integral part the research team and can ask some of the most probing questions of our methods and certainly the process. They are hugely valuable at all stages of the execution of a piece of research.

“They contribute to devising the methods and process and even something like the sense of the question. They have a good grasp of research methods but it is their practical experience and ability to deliver it that is absolutely essential.”

This sentiment is backed up by Marilyn Laird, DHSRU and senior trials administrator. She said: “We have learned many lessons throughout the journeys of the trials and, if we had to do the trials again, we would make sure that we had dental research nurses and hygienist/therapists involved from the very start.

“They all play a key role both strategically and operationally. Our team know the way the practices work, they are familiar with the processes, challenges, day-to-day running and paperwork required. They are a crucial link between the trial admin office and the practices.

“The richness and quality of information that they collect during visits feeds back into the decision making and planning.”

In practice

The team themselves all have a background working in clinical dentistry and therefore know the pressures and demands of a busy general practice. This gives them a vital insight and allows them to work alongside and not on top of, the participating practices.

Laura Lovelock, who was recruited for the first round of IQuaD and has just come back on board for the next phase, explained what it is about research that excites her. She said: “I love being out in practices, recruiting patients and getting them excited and enthused about clinical research. It’s great to meet fellow dental professionals across the country, seeing different ways of working and being at the forefront of improving practice.

“Research is what drives dentistry forward and helps to give us the best possible practice, so it is great to be a part of that.”

And Jill Gouick echoed that sentiment by saying: “The best part is always seeing the patients and that will always be the most exciting part. But I’m also very enthused about the outcomes, because we are playing an important role in making new discoveries and uncovering information that could really make a difference to the future of the patients’ dental care.”

“I think if you enjoy working with the public,” said Fiona Mitchell, “you don’t lose that with dental research. People often think, as I did initially, that dental research doesn’t move out of the office or laboratory and that you are immersed in paperwork. Dental research isn’t like that.

“We travel all over the UK and have contact with many participants and dental professionals in their own clinical settings. This is very rewarding and I feel very fortunate to be part of this team.”

And, while Fiona Ord reiterated her colleagues’ enjoyment of working with patients and practices, she said that she is motivated by the evidence.

She said: “I enjoy being part of the research team, adding to the knowledge base, improving the quality of care delivered to patients as part of an evidence-based approach.”

With their clinical experience, the research team are expertly placed to communicate with patients and put them at ease, before and often during the research itself.

Fiona Ord explained that, while they are in the practice, their interpersonal skills come to the fore. She said: “When we visit a practice to carry out research, the patients see that we are researchers who have a knowledge and understanding of dental treatments. We are dental professionals gathering data for the trial.”

Jill Gouick continued: “As a clinical researcher, we can provide the support, understanding and a more holistic view of their visit.”

Laura Lovelock added: “One of the key characteristics of a clinical dental research professional, as with any time you are treating patients, is being non-judgemental, having an open mind and being open with patients.

“Making the patients feel relaxed about taking part in research, answering all their questions and keeping them well informed are essential in the delivery of our role.”

Learning curve

“Although I have been working in dental research and on trials for many years,” said Marilyn Laird, “every day is still a school day on a trial. It’s a constant learning process.

“Whether you are an administrator, health economist, researcher or investigator, everyone has a voice and the diversity of opinions are always welcome and valued.”

And Laura Lovelock insisted that the team ethic is prevalent throughout the research process. She said: “Particularly here at the DHSRU, we meet regularly for team discussions. The planning takes on a collaborative approach and, as a team, we drive the trial forward. Investigators and collaborators always take our comments and advice on board.”

Compared to when they started on the IQuaD trial in 2012, Jill Gouick reflected how their experience and involvement so far has enabled them to provide more and more advice and input to their colleagues. She said: “When we first started we all came in brand new to research.

“Now, however, as we are going in to our fourth trial, we can almost predict what would be best practice, and the requirements for each element and stage of the research study/trial.

“We are able to advise straight away, from our knowledge gained through meticulous, ethically-driven planning of previous trials, what has worked best, through experience and from patients and practices feeding back to us.”

Join the team

Hygienist/Therapists

The DHSRU is looking to recruit two hygienist/therapists to work alongside the current dental research team. The first post is three days per week and the second is full-time. Deadline for applications is 24 April 2015.

For more details and to apply, visit bit.ly/dundeeresearchjobs

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