Bristol comes out fighting

Bristol is home to one of the smallest dental schools in the UK, a fact its staff and students are very proud of. This is because it allows the school to retain a friendly and intimate feel, while its staff can focus on each student’s individual needs.

The set-up seems to suit the school as it enjoys a good reputation and regularly receives positive feedback from its students. However, not so long ago, things weren’t that rosy. In 1999, a government review led to the dental school plunging to the bottom of the league tables and the results were reported widely in the national press.

Seven years ago, every UK university took part in a process called Subject Review. This was a government initiative aimed at assessing the merits and failures of every subject taught at each university in the UK.

Dental schools were no exception and Bristol was awarded a score of 18 out of 24, leaving it languishing at the bottom of the dental school league tables. The accompanying report heavily criticised both the school’s curriculum and assessment methods.

Since then, Bristol has been working hard to put right the things the report said it had got wrong, and its efforts seem to be paying off.

The school that greets you in 2006 couldn’t be more different. The mood there is now positive, it has tackled its problems and is embracing the future. However, they have admitted to finding it difficult to shake off the negative image that the low mark left them with.

Professor Jonathan Sandy, head of teaching at Bristol dental school, said: ‘It is unfortunate that Subject Review was a one-off government exercise as we have never managed to get rid of the “18 out of 24” tag.

‘However, in the last four years we have gone through huge changes with the way we deliver teaching and how we quality assure it. We have also been through a departmental review (an internal study of teaching quality and research in the university) as well as, in common with all dental schools, a GDC visit.

‘We are also the only dental school to take part in Institutional Audit, which has replaced Subject Review. Rather than looking at every subject, external assessors look at the institution as a whole and drill down to only a few disciplines, usually one from each faculty, with an audit trail.

‘We came out of it extremely well and we were singled out for examples of good practice in peer review and student feedback. It is just a shame this is not reflected in the league tables. However, we know that we have come a heck of a long way and we are very pleased with what we have done.’

Following the publication of the Subject Review’s findings, the staff set about making improvements in the areas that were highlighted as weaknesses.

Their first task was to implement a quality assurance system within the school and make changes to their assessment procedure, something Professor Sandy admits was not easy to do.

‘After the Subject Review the first thing we did was to examine the report. The Dental Education Committee went through everything and particularly focused on assessment, which we were hopelessly inconsistent on.

‘We decided to standardise assessment and we also put everyone in the school through a peer review course and made it into a rolling programme. Slowly, we developed a culture within the school of quality assurance for education, so much so that people now won’t move without thinking about quality assurance first.’

Their next step was to look at the school’s curriculum, a review it had been attempting since 1995, but had put on hold while other problems took priority. It is something they are still putting the finishing touches to now.

The staff and stakeholders have spent the past nine months developing the new curriculum and it should be ready to roll out in time for the start of the new

academic year.

The content of the first year has been left almost untouched and continues to feature the pre-clinical material needed to support the following subsequent years of study. The second year, however, has been completely overhauled.

Professor Sandy says: ‘We have responded to student feedback and they made clear they wanted more clinical contact earlier on in the course. Therefore, we are adding clinical elements earlier on and this will begin from the second year. The first term of year two will be an oral biology term and it will tell students what it is they need to know in terms of the biology that is relevant to their clinical practice.

‘This term is also quite useful if graduate entry becomes a feature of the programme, because we can start those people with a relevant biomedical sciences degree at this point. In the subsequent two terms the aim is to make the students dental-nurse competent and get them to nurse for senior students. We believe this will be a good way of setting up a big brother/big sister type system and will benefit the students enormously.’

Having an understanding of the part every member of the dental team plays is an important feature of the new curriculum. For instance, students will be taught hygienist skills too and will even spend some time working in a reception area to emphasise the importance of team working in their future careers.

One new element of the course that may not prove so popular with the students is the changes being made to their elective period, which begins in the second year of study and ends in year four.

Previously, the elective period consisted of an individual project and allowed the students the opportunity to study abroad. Now, they will have to embark on a group project and Professor Sandy admits that students might not necessarily get to go abroad during this time. This is because of concerns over the educational value of these trips and health and safety issues.

He said: ‘We were worried that electives were becoming educationally unsound. We were putting the students in situations that we didn’t feel were safe, not only from an educational point of view but also from a health point of view. We had students coming back with needle stick injuries from places where they could have been picking up nasty diseases and we had a couple of students who were exposed to irradiation because the particular clinic they went to didn’t believe in radiation hygiene.

‘Consequently, we will put them together as a group to do a project. There is no reason why some of that project can’t be done abroad but they will all need to go in order to do that. It is a much better way to ensure they are safe and that the educational element is properly monitored.’

Bristol still has a long way to go to put the ghosts of 1999 to rest, but it is making progress and its future is looking bright. Plans to increase its student intake and widen its outreach programme are afoot, and there are the changes to the new curriculum too. So, it shouldn’t be too long before this small fish in a big pond comes of age.

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