Evaluation of Restorative Dentistry Specialty Registrars’ Clinical Experience of Developmental Disorders: A Survey

Background

Specialty Registrars in Restorative Dentistry (StRs) should be competent in the independent restorative management of patients with developmental disorders including hypodontia and cleft lip/palate upon completion of their specialist training.1 Knowledge and management may be assessed via the Intercollegiate Specialty Fellowship Examination (ISFE) in Restorative Dentistry.2

Objective

The aim of this study was to collate and compare data on the training and experience of StRs in the management of patients with developmental disorders across different training units within the British Isles.

Methods

Questionnaires were distributed to all StRs attending the Annual General Meeting of the Specialty Registrars in Restorative Dentistry Group, Belfast, in October 2015. Participants were asked to rate their confidence and experience of assessing and planning treatment for patients with developmental disorders, construction of appropriate prostheses, and provision of dental implants. Respondents were also asked to record clinical supervision and didactic teaching at their unit, and to rate their confidence of passing a future ISFE station assessing knowledge of developmental disorders.

Results

Responses were obtained from 32 StRs (n=32) training within all five countries of the British Isles. The majority of respondents were based in England (72%) with three in Wales, and two in each of Scotland, Northern Ireland, and the Republic of Ireland. Approximately one third of respondents (34%) were in the final years of training (years 4-6). Almost half of the StRs reported that they were not confident of independently assessing (44%) new patients with a developmental disorder, with larger numbers (72%) indicating a lack of confidence in treatment planning. Six respondents rated their experience of treating obturator patients as ‘poor’ or ‘very poor’. The majority (56%) rated their experience of implant provision in these cases as ‘good’ or ‘excellent’ with three-quarters (75%) rating clinical supervision at their unit as ‘good’ or ‘excellent’. Less than half (41%) rated the didactic teaching at their unit as ‘good’ or ‘excellent’, and only 8 StRs indicated that they were confident of passing an ISFE station focused on developmental disorders.

Conclusion

Experience and training regarding patients with developmental disorders is inconsistent for StRs across the British Isles with a number of trainees reporting a lack of clinical exposure.

How to promote professional competence and identity in social work students

Background: Field placement experiences are frequently cited in the literature as having most impact on a student social worker’s learning as they emerge into the profession. Placements are integral to the development of practice competence and in acquiring a sense of social work identity. However research on the effectiveness of educational strategies used to deliver learning and assess competence during placement are scarce. Internationally, pressures to meet increasing numbers of student enrolments have raised concerns about the potential impact on the quality of placements and practice teaching provided. These pressures may also impact on the appropriate transfer and application of learning to the student’s practice.
Aim: To identify learning activities rated most useful for developing professional practice competence and professional identity of social work students.
Method: Data were collected from 396 students who successfully completed their first or final placement during 2013-2014 and were registered at one of two Universities in Northern Ireland. Students completed a self-administered questionnaire which covered: placement setting and service user group; type of supervision model; frequency of undertaking specific learning activities; who provided the learning; which activities contributed to their developing professional competence and identity and their overall satisfaction.
Our findings confirmed the centrality of the supervisory relationship as the vehicle to enable quality student learning. Shadowing others, receiving regular supervision and receiving constructive feedback were the tasks that students reported as ‘most useful’ to developing professional identity, competence and readiness to practice. Disturbingly over 50% of students reported that linking practice to the professional codes, practice foci and key roles were not valued as ‘useful’ in terms of readiness to practice, feeling competent and developing professional social work identity. These results offer strong insights into how both the University and the practice placement environment needs to better prepare, assess and support students during practice placements in the field.

Beyond Typologies: Foregrounding Meaning and Motive in Domestic Violence Perpetration

Within the study of domestic violence typological approaches have gained prominence in part as a response to the wider feminist canon that presumes perpetrators are all simply motivated by male power. In this article we use a single case study to query the presumption inherent in the most commonly used typological approaches that offender motivations remain largely static overtime and can be read off easily from self-reports or official records. We conclude by pointing to the need, both for academics and practitioners, to engage interpretively with the specific meanings acts of violence hold for domestic violence perpetrators - informed as they can be by sexist values, perceptions of entitlement and a specific history of conflict, suspicion or grievance – that can change who they are and the way they behave in the aftermath of assaults and breakups, as the foreground of crime is reincorporated into a background narrative.

Experiencing Youth Justice and Penality

Much of the recent literature on youth justice has focused on administrative aspects of the system and the socio-political contexts that have led to the ‘production’ of the youthful offender as a subject and locus of intervention. This has largely been driven by the extent to which youth justice has been crafted as a distinct penal sphere, evident in its unyoking from universal children’s services (Muncie and Goldson, 2013) and the establishment of separate agencies to administer and govern this ‘system’ (Souhami, 2014). Driven by policy hyperactivity and a plethora of legislation expanding the reach of the system, for much of the 1990s and 2000s increasing numbers of young people were brought under its gaze.

Particular attention has been paid to the impact of neo-liberal governance on the discourses, rationales and philosophies underpinning contemporary youth justice policy and practice. Writing specifically in the English and Welsh context, several authors have identified that the resulting ‘system’ embodies multiple, contradictory and competing discourses (Muncie, 2006; Fergusson, 2007; Gray, 2013). Within this ‘melting pot’ Fergusson (2007) notes the disjuncture between policy rhetoric, implementation and lived experience and Phoenix (2015) argues that systems-based analyses, much in favour amongst academics, foreclose a wider consideration of questions of what ‘justice’ actually means.

Recent attention towards the perspectives of practitioners working in this sphere has pointed to greater nuances than broader penal narratives suggest (see: Field, 2007; Briggs, 2013; Gray, 2013; Kelly and Armitage, 2015). Yet similar attention has not been given to experiences of youth justice (for an exception see – Phoenix and Kelly, 2013). However, it is precisely young people’s experiences, which would add significantly to current knowledge and potentially bridge the gap between discussions about penal philosophies, how youth justice policies are framed, how they are enacted and how they are experienced.

This chapter provides an overview of recent developments in the field of youth justice and penality in the United Kingdom. The chapter argues that a theoretical focus on macro-level trends (Hannah-Moffat and Lynch, 2012), alongside a narrowly defined research agenda, have largely excluded young people’s experiences of justice and punishment from contemporary analysis. Drawing on young people experiences of different aspects of youth justice in Northern Ireland and beyond, the chapter illuminates what a close understanding of lived experience can add to knowledge. In particular it demonstrates that the effects of interventions can be different to their aims and intentions; and that re-instating the youth experience can add support to calls for greater attention to wider issues of social justice.