Vocational training for all
Making sure that hygienist/therapist vocational training (HTVT) meets the same standards as BDS graduates, is the aim of new programme lead Lorraine Keith
Vocational training for dental hygienists/therapists should mirror, as closely as possible, the same as the training for dentists. That is the belief of Lorraine Keith who is the hygienist/therapist vocational training advisor for the programme in Scotland.
The training course, which has been running since 2006 in its current format, is for hygienist/therapist graduates. Beginning in August and completing the following July, it involves an induction day and 10 study days, which take place at locations across the country. Those study days cover most of the elements within the scope of a hygienist/therapist practice. In other words, subjects such as paediatrics, periodontics, restorative dentistry, smoking cessation, radiography, oral medicine, medical emergencies and clinical audit. A final study day involves presenting a case study of the holistic care of a patient to their peers.
Trainees also complete a ‘test of knowledge’ covering areas such as management and communication that they may not have studied as an undergraduate. Later in their year, they undertake patient assessment questionnaires which involves gathering feedback from a minimum of 30 patients they have seen.
This year, despite having 10 vacancies, we only have eight training posts, which makes competition fierce
“The aim is to match the training for BDS graduates, as closely as possible,” said Lorraine, who took up her role in January 2016 and is the first hygienist/therapist to assume the post.
“I’m currently an associate lecturer and outreach tutor at Glasgow Caledonian University and NHS Education for Scotland (NES) decided it was appropriate to have a hygienist/therapist in the role.”
Vocational training for hygienists/therapists, unlike dentists, is currently part time. It takes up six sessions, in other words three days a week. On the other two days, trainees can, in theory, take work elsewhere or within the training practice, which, among other things, means the practice does not have to find surgery space five days a week if this is not practicable, and the trainee can supplement their salary in another, or the same practice.
In addition, hygienist/therapist vocational training is delivered as a national programme, rather than regionally as is the case with most dentists. “The reason for that is the comparatively low number of spaces available,” said Lorraine. “At the moment there is the potential for around 45 hygienist/therapists to graduate from Scotland’s four dental schools every year. However, this year, despite having 10 vacancies, we only have eight training posts, which makes competition very fierce.”
More trainers please
Part of the solution, she suggests, is to increase the number of trainers. At the moment there is one trainer in Edinburgh, one in Aberdeen, three in the Glasgow area and three further north. Circumstances dictate that the number available fluctuates constantly. “If, for example, a trainer decides to take on the trainee she/he is working with, there is maybe no capacity to take on another graduate the following year.”
Unsurprisingly, NES is always looking to recruit new trainers. Lorraine added: “There is the possibility to be a multi- trainer – to take on both a dentist and a hygienist or take on two HTVTs if that model suited the practice better. Additionally, it would be possible for two trainers in different practices to share a HTVT.
“I know the GDC has strong emphasis on joint undergraduate training. It would seem to make sense, then, to take that concept to postgraduate level and have dentists and hygienists/therapists training alongside one another. They could learn from each other and learn more about the patient journey together. That would be good for the individuals involved, the practice, team building and, most importantly, the patient.
“We arrange mentoring visits for prospective trainers. In essence, the demands are the same as for dental training, except equipment required for vocational dental hygienist/therapists (VDHT) may be slightly different. Requirements include a proper decontamination area and a nurse available at all times. “A potential new trainer would attend ‘START’ training,” said Lorraine. “Among other things, this prepares them for carrying out the trainee assessments known as LEPS (longitudinal evaluation of performance) and conducting fortnightly tutorials.”
Although it involves a certain commitment, being a training practice brings its benefits. As well as playing a part in preparing the dental workforce of the future, there’s a payment for having a trainee in the practice.
And, because the time demands are currently fewer than for a dental trainee, hygienist/therapist vocational training offers more flexibility. There is no need for the practice owner to be the trainer – that can be taken on by an associate. Since trainers can also attend study days, there’s the chance to refresh your knowledge and gain valuable CPD hours.
The ultimate aim for everyone involved is for the trainee to achieve ‘satisfactory completion’ at the end of the year. As Lorraine pointed out, if they don’t attain that it does not block career progression. “Someone who has undergone vocational training is in a better position than someone who has gone straight from being an undergraduate to the working environment. They’ve benefited from a year of increasing their knowledge, gaining confidence and undertaking assessments with trainer support.”
Knowledge and hands-on experience
Participants on the current hygienist/therapist vocational training programme are gaining greater knowledge and hands-on experience.
Katie Lee is at a training practice in the north of Scotland. She said: “I’m enjoying working in a supported environment where there’s an open-door policy and I can approach the dentists whenever I need help. I’m getting a lot of practice with paediatrics, adult and elderly patients. I’m doing periodontal treatment and restorative as well.”
Rafeen Altaf, also training in the north, said: “I’ve found the vocational training scheme a good transition from university. Until now, I’ve seen a lot of adult periodontal treatment but I’m gradually seeing a greater variety of work, including restorative.”
Mia Mortimer is at a practice near Glasgow. She said: “It’s a very large practice with a lot of associates and a large, loyal patient base. I do a lot of restorative work on younger patients, and see a lot of adult and older people – I’m really able to utilise my skills. There are a few associates who have recently come out of vocational training so they really understand my situation.”
Jyoti Sumel, from Birmingham, is at a training practice in Glasgow. She added: “This has really got me used to the way a practice works. At university you have hour-long appointments; in practice it’s 40 minutes or half an hour. It helps you get faster and gain confidence. I get a good mix, including patients with complicated medical histories.”