Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Research
  • Published:

Hospital dental staff attitudes to guide education and training in patient safety: a study with a focus on qualitative data

British Dental Journal volume 235, pages 623–628 (2023)Cite this article

Abstract

Objectives This study aimed to determine attitudes of current NHS dental hospital trainees at dental core trainee and speciality registrar level, plus consultant trainers, to guide shaping the direction of education and training in patient safety. The study was a locally based project in a single dental hospital setting at an acute NHS London Trust.

Methods This study employed a survey and interviews, with emphasis on qualitative data utilised. Interviews were aimed at hospital clinical dental staff. The survey and focus groups were aimed at trainees. The one-on-one interview sessions were aimed at trainers.

Results Findings demonstrated that both trainers and trainees see patient safety as a priority and there are gaps in education and training. Four overarching themes were seen as important to trainees and trainers to support education and training in patient safety: culture, knowledge, time to train and engagement.

Conclusions Recommendations in this dental hospital setting focused on culture change and dental-specific experiential learning based on spiral curricula. Education and training in patient safety should be introduced at undergraduate level, with regular team training acknowledging the need for consistent engagement of all key stakeholders.

Key points

  • In this dental hospital, patient safety is deemed a priority and important by dental core trainees and specialist registrars in clinical training, and by consultant trainers.

  • Culture, knowledge, time to train and engagement are four key themes to emerge as essentials to support education and training in patient safety.

  • The National patient safety syllabus 2.0 will satisfy an unmet need. Nevertheless, education and training in patient safety requires a change in culture, should be dental-specific and requires regular team training, patient involvement, spiral curricula and iterative training.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Kohn L T, Corrigan J, Donaldson M S. To Err is Human: Building a Safer Health System. Washington DC: National Academies Press, 2000.

  2. World Health Organisation. Quality of care: patient safety. 2002. Available at https://apps.who.int/gb/archive/pdf_files/WHA55/ewha5518.pdf?ua=1 (accessed October 2022).

  3. Panagioti M, Khan K, Keers R N et al. Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. BMJ 2019; 366: 4185.

  4. UK Government. Report of the Mid Staffordshire NHS Foundation Trust Public Enquiry. 2013. Available at https://www.gov.uk/government/publications/report-of-the-mid-staffordshire-nhs-foundation-trust-public-inquiry (accessed October 2022).

  5. Pemberton M N. Developing patient safety in dentistry. Br Dent J 2014; 217: 335-337.

  6. NHS England. Never Events data: summary 2012/13. Available at https://webarchive.nationalarchives.gov.uk/ukgwa/20161104182833/https://www.england.nhs.uk/patientsafety/never-events/ne-data/ (accessed November 2022).

  7. Bailey E. Contemporary views of dental practitioners on patient safety. Br Dent J 2015; 219: 535-540.

  8. Black I, Bowie P. Patient safety in dentistry: development of a candidate 'never event' list for primary care. Br Dent J 2017; 222: 782-788.

  9. Ensaldo-Carrasco E, Sheikh A, Creswell K, Bedi R, Carson-Stevens A, Sheikh A. Patient Safety Incidents in Primary Care Dentistry in England and Wales: A Mixed-Methods Study. J Patient Saf 2018; 17: 1383-1393.

  10. Care Quality Commission. Opening the door to change. 2018. Available at https://www.cqc.org.uk/publications/themed-work/opening-door-change (accessed October 2022).

  11. NHS England and NHS Improvement. The NHS Patient Safety Strategy: Safer culture, safer systems, safer patients. 2019. Available at https://www.england.nhs.uk/wp-content/uploads/2020/08/190708_Patient_Safety_Strategy_for_website_v4.pdf (accessed October 2022).

  12. Academy of Medical Royal Colleges. National patient safety syllabus 1.0: Training for all NHS staff. 2020. Available at https://www.aomrc.org.uk/wp-content/uploads/2020/01/National_Patient_safety_syllabus_v1.0_0120.pdf (accessed October 2022).

  13. Health Education England. National Patient Safety Syllabus 2.0. 2022. Available at https://www.hee.nhs.uk/our-work/patient-safety (accessed October 2022).

  14. Illing J, Corbett S, Kehoe A et al. How Does the Education and Training of Health and Social Care Staff Transfer to Practice and Benefit Patients? A Realist Approach. 2018. Available at https://eprints.ncl.ac.uk/file_store/production/250597/0918BE55-648C-439F-8706-499322906059.pdf (accessed October 2022).

  15. Health Education England. Evaluation of Education and Training interventions for Patient Safety. 2016. Available at https://www.hee.nhs.uk/sites/default/files/documents/Evaluation%20of%20Education%20and%20Training%20Interventions%20for%20Patient%20Safety%20-%20Imperial%20College%20London.pdf (accessed October 2022).

  16. National Patient Safety Agency. Manchester Patient Safety Framework (MaPSaF). 2006. Available at https://webarchive.nationalarchives.gov.uk/ukgwa/20171030124256/http://www.nrls.npsa.nhs.uk/resources/?EntryId45=59796 (accessed October 2022).

  17. Merriam S B, Tisdell E J. Qualitative Research: A Guide to Design and Implementation. 4th ed. San Francisco: Jossey-Bass, 2016.

  18. General Dental Council. The safe practitioner: A framework of behaviours and outcomes for dental professional education. 2022. Available at https://www.gdc-uk.org/docs/default-source/safe-practitioner/gdc-safe-practitioner-consultation.pdf?sfvrsn=fc6a7273_9 (accessed March 2023).

  19. General Dental Council. Speciality Curricula. Available at https://www.gdc-uk.org/education-cpd/quality-assurance/specialty-curricula (accessed March 2023).

  20. NHS England. A just culture guide. 2018. Available at https://www.england.nhs.uk/patient-safety/a-just-culture-guide/ (accessed October 2022).

  21. Yansane A, Lee J H, Hebballi N et al. Assessing the Patient Safety Culture in Dentistry. JDR Clin Trans Res 2020; 5: 399-408.

  22. Renton T, Master S. The complexity of patient safety reporting systems in UK dentistry. Br Dent J 2016; 221: 517-524.

  23. Palmer J C, Blanchard J R, Jones J, Bailey E. Attitudes of dental undergraduate students towards patient safety in a UK dental school. Eur J Dent Educ 2019;23: 127-134.

  24. NHS England. Never Events Data. Available at https://www.england.nhs.uk/patient-safety/never-events-data/ (accessed October 2022).

  25. Ensaldo-Carrasco E, Carson-Stevens A, Cresswell K, Bedi R, Sheikh A. Developing agreement on never events in primary care dentistry: an international eDelphi study. Br Dent J 2018; 224: 733-740.

  26. NHS England. Revised Never Events policy and framework. Available at https://www.england.nhs.uk/patient-safety/revised-never-events-policy-and-framework/ (accessed September 2023).

  27. Wright S, Ucer C, Speechley S. The perceived frequency and impact of adverse events in dentistry. Faculty Dent J 2018; 9: 14-19.

  28. Harden R M, Laidlaw J M. Essential Skills for a Medical Teacher. 3rd ed. Oxford: Elsevier, 2021.

  29. Arora S, Tsang F, Kekecs Z, Shah N, Archer S, Smith J, Darzi A. Patient Safety Education 20 Years After the Institute of Medicine Report: Results from a Cross-sectional National Survey. J Patient Saf 2021; 17: 1884-1888.

  30. Health Education England. Commission on Education and Training for Patient Safety Report. 2016. Available at https://www.hee.nhs.uk/sites/default/files/documents/Commission%20on%20Education%20and%20Training%20for%20Patient%20Safety%20-%20progress%20report.pdf (accessed October 2022).

  31. General Medical Council. First, do no harm: Enhancing patient safety in undergraduate medical education.2015. Available at https://www.gmc-uk.org/-/media/documents/First_do_no_harm_patient_safety_in_undergrad_education_FINAL.pdf_62483215.pdf (accessed October 2022).

  32. Health Education England. Human Factors and Healthcare: Evidencing the impact of Human Factors training to support improvements in patient safety and to contribute to cultural change.2019. Available at https://www.hee.nhs.uk/sites/default/files/documents/Health%20Education%20England%20and%20CIEHF%20-%20Human%20Factors%20and%20Healthcare%20Report.pdf (accessed October 2022).

  33. Shelley A, Horner K. Questionnaire surveys - sources of error and implications for design, reporting and appraisal. Br Dent J 2021; 230: 251-258.

  34. NHS England. Improving Patient Safety Culture - a practical guide. 2023. Available at https://www.england.nhs.uk/long-read/improving-patient-safety-culture-a-practical-guide/ (accessed May 2023).

  35. Kirkpatrick D L, Kirkpatrick J. Evaluating Training Programmes. 3rd ed. San Francisco: Berrett-Koehler, 2013.

Download references

Acknowledgements

The authors wish to thank all the participants including the DCT/StRs and CTs at Barts Health Dental Hospital who gave time to complete the survey and or be interviewed. Also to consultant colleagues who advised on the study at various stages. Thanks also to George Morgan who helped set up the Qualtrics survey. Imperial College London, Faculty in Patient Safety and Brendan Delaney, the course director, require special mention, as without their support, this project would not have been possible.

Author information

Authors and Affiliations

  1. Consultant in Restorative Dentistry, The Dental Hospital Barts Health Trust, Royal London Hospital, UK

    Claire L. Morgan

  2. Past Chair, MSc Dissertations Department of Surgery and Cancer, Imperial College, UK; Dean, Online Learning and Global Engagement, Oregon Institute of Technology, USA

    Ruth C. Black

Authors
  1. Claire L. Morgan
    View author publications

    Search author on:PubMed Google Scholar

  2. Ruth C. Black
    View author publications

    Search author on:PubMed Google Scholar

Contributions

Claire L. Morgan was the main researcher and author of this study, which was conducted in partial fulfilment of a Master of Science degree in Patient Safety at Imperial College awarded in 2021. Ruth C. Black was the research supervisor for the dissertation component of the MSc in Patient Safety at Imperial College London. Ruth C. Black advised and guided this project with a particular emphasis on methodological design and development, as well as strategies and approaches to data collection and data analysis and best practices in qualitative research.

Corresponding author

Correspondence to Claire L. Morgan.

Ethics declarations

The authors declare no conflicts of interest.

This was a local project and study approval was obtained from the Clinical Effectiveness Unit of the Trust and from Imperial College London. Ethical approval was not required for this study as there was no patient-identifiable information and the survey of NHS staff was anonymous. Participants all gave written consent to participate in the survey/interviews and to publication.

All anonymised data produced from this study is held by the corresponding author in a secure location. This will be retained for five years from the date of dissertation submission, 11 August 2021, as per Imperial College requirements.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

L. Morgan, C., C. Black, R. Hospital dental staff attitudes to guide education and training in patient safety: a study with a focus on qualitative data. Br Dent J 235, 623–628 (2023). https://doi.org/10.1038/s41415-023-6411-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41415-023-6411-7

This article is cited by

Search

Advanced search

Quick links