key: cord-345708-hlnjzunb authors: Mahendran, Krishantini; Yogarajah, Sangeetha; Herbert, Cameron; Nayee, Shalini; Ormond, Martyn title: COVID‐19 and Postgraduate Dental Training—A commentary date: 2020-09-29 journal: Eur J Dent Educ DOI: 10.1111/eje.12600 sha: doc_id: 345708 cord_uid: hlnjzunb In this commentary, we discuss the short‐term and long‐term implications of COVID‐19 on postgraduate dental training in the UK, specifically Dental Core Training (DCT) and Specialty Training. Although this commentary focuses on the authors’ experiences within Guy's and St Thomas’ NHS Foundation Trust (GSTT) in London, we hope that our viewpoint will resonate with dental postgraduate trainees across Europe and may guide further discussion in this area. We also reflect on adaptations that may be required if there are any future disruptions to dental postgraduate training in the UK. team working and leadership, (c) clinical safety and quality, and (d) good clinical care. Redeployment was a key component to the preparedness and response to COVID-19. 6 We outline how DCTs have developed new skills and continued to meet the competencies within the UK DCT Curriculum throughout this process. DCTs were redeployed to a range of departments including community renal dialysis units, critical care units and inpatient COVID-19 wards. This was supported by formal and informal teaching sessions to expand learning opportunities. These learning experiences enabled redeployed DCTs to perform successfully in their new roles. However, throughout redeployment, recognition of professional limitations was paramount to ensure that DCTs worked within their competencies. As DCTs integrated into large multidisciplinary medical teams, there was scope for developing competencies in communication and team working. DCTs worked alongside doctors, pharmacists, occupational therapists, specialist nurses such as dialysis and diabetic nurses, ward clerks and patient co-ordinators. As staff sickness and shortages increased, DCTs offered their skills where appropriate to reduce the workload for the rest of the team, without compromising patient safety. This approach required DCTs to demonstrate personal agency and take the initiative to integrate within a team that was largely unaware of how dentists could support the wider healthcare team. Communication skills were also developed through interactions with patients and their relatives. External visitors, including relatives, were banned from the wards to reduce the risk of disease transmission, and DCTs were able to provide extra support for patients and to update family members by telephone. These conversations were often challenging but provided valuable opportunities to reflect upon and enhance communication skills. Supporting the care of inpatients allowed DCTs to gain exposure to patients with complex medical conditions. In addition to gaining greater understanding of specific medical conditions such as diabetes mellitus, chronic kidney disease and acute kidney injury, DCTs developed greater understanding of the holistic assessment of patients with multiple co-morbidities and improved knowledge regarding polypharmacy and prescribing. These skills are directly transferrable to a dental setting and will facilitate higher quality patient care. Within the dental hospital, DCTs supported senior staff members transform existing services through reviewing and adapting local policies, trialling new systems of working and creating local standard operating procedures. DCTs supported the introduction of streamlined patient care pathways to minimise the number of hospital visits. By F I G U R E 1 NHS dental training pathway engaging in these initiatives, trainees were able to contribute to a growing body of national recommendations on providing effective and safe dental care for patients in all settings across the country. Some DCTs were redeployed to maintain oral hygiene for ventilated ITU patients under the "Mouth Care Matters" scheme. 7 This experience offered trainees the opportunity to actively promote oral health in a medical setting and share their techniques with nondental colleagues. Dental Specialty Training was not suspended in the same way as DCT. 8 With the suspension of many non-essential services within healthcare, courses and conferences were also cancelled. Specialty With the suspension of many dental specialty clinics, clinicians were afforded a unique opportunity to pursue research and departmental quality improvement projects. Those redeployed were able to engage with projects within other departments giving them insight into other research/quality improvement methods that could be brought back to dental specialties. Nevertheless, there may have been a deleterious impact for some academic trainees, with the cancellation of training opportunities, and the temporary suspension of non-COVID-related research within most university biomedical departments in the UK. The COVID-19 pandemic has required drastic changes in the way in which healthcare is delivered. During specialty training, it would be expected that trainees obtain insight into the structures of the NHS and healthcare delivery. The pandemic has provided a unique opportunity for trainees to engage in addressing the challenges of healthcare transformation: trainees worked alongside senior clinical colleagues to remodel current systems and evaluate these new ways of working. The COVID-19 pandemic has accelerated the pace of adoption of the NHS vision set out in the long-term plan, 13 in particular, the reduction of outpatient visits by a third over five years. This must be recognised when assessing current trainees' progress and importantly should lead to a more rapid review of specialty training curricula. Euro.who.int. WHO announces COVID-19 outbreak a pandemic Important and urgent -next steps on NHS response to COVID-19 Joint statement on arrangements for dental and dental care professional students and recent graduates, while restrictions are in place to control the spread of COVID-19 UK Committee of Postgraduate Dental Deans and Directors (COPDEND) Redeploying the clinical dental workforce to support the NHS clinical delivery plan for COVID-19 Improving Oral Health of Older Persons Initiative. Mouth care matters FAQ for dental specialty trainees during current Covid-19 situation https://madei nheene.hee.nhs.uk/Porta ls/0/FAQ%202%20Den tal%20Cor e%20Tra ining %2023%20Apr il Advancing Dental Care: Education and training review -final report Higher specialist training documents and curricula -Royal College of Surgeons Specialty training curriculum for oral medicine The NHS Long Term Plan Not required. Data sharing is not applicable to this article as no new data were created or analysed. https://orcid.org/0000-0002-8864-6812Sangeetha Yogarajah https://orcid.org/0000-0003-0844-8347Cameron Herbert https://orcid.org/0000-0003-1111-5412Shalini Nayee https://orcid.org/0000-0001-5014-1213Martyn Ormond https://orcid.org/0000-0002-2586-2200