about mjdf
DESCRIPTION
mjdfTRANSCRIPT
The MJDF
A thoroughly modern
assessment
• Why?
• Where?
• What?
• How?
• When?
Diploma of Membership of the Joint
Dental Faculties at the RCS
Why?
• Modernising Medical Careers (MMC)
2003 DoH initiative
• “Aims to develop demonstrably
competent doctors who are skilled at
communicating and working as
effective members of a team.”
MMC
• Two-year foundation training
• Demonstrate competence against set
standards
• Develop experience in a range of
specialties
• Gain insight into career options or
build a wider appreciation of medicine
before embarking on specialist training
• Focused on the development of a
flexible workforce of doctors
• Competent at dealing with the
acutely ill
• Effective at communicating with
patients and colleagues alike
MMC
• The Department of Health
• UK Dental General Professional
Training Liaison Group
A Curriculum for UK Dental Foundation
Programme Training
Why?
What?
• UK General Professional
Training Liaison Group
• COPDEND (Committee of
Postgraduate Deans and
Directors)
Foundation Training
Curriculum
Four domains
Major competencies
within each domain
Clinical domain
• Examination & diagnosis
• Treatment planning & patient
management
• Health promotion & prevention
• Medical & dental emergencies
• Pain & anxiety control
Clinical domain 2
• Perio & soft tissue management
• Hard & soft tissue surgery
• Non-surgical management of
hard & soft tissues
• Developing dentition
• Restoration of teeth
• Replacement of teeth
Assessing Periodontal Risks
Is this done on all patients?
Assessing Periodontal Risks
Periodontal Disease Risk factors
•Oral Hygiene/ plaque control
•Smoking
•Diabetes
•Drugs, Systemic Disease
•Nutrition
•Genetics
Effects of not managing periodontal risk
Assessing Caries Risks
Caries Risk factors
•Diet
•Oral Hygiene
•Tooth structure
•Plaque retentive factors
•Salivary flow
•Socio-economic group
Effects of not managing caries risk
Whose fault was this, the dentist’s or the patient’s?
• Ethics
• Patients
• Self
• Clinical team & peers
Professionalism
Effects of not managing caries risk
Professionalism
1 or 2 areas of
concern per doctor
(1 case)
9 or more areas of
concern per doctor
(3 cases)
3 or 4 areas of
concern per doctor
(8 cases)
5 or 6 areas of
concern per doctor
(16 cases)7 or 8 areas of
concern per doctor
(22 cases)
Communication
• Patient & family
• Clinical & team
• Peers
• Other professionals
Team Training
Making it happen in the real
world
“Complaints are
jewels to be
treasured”
Significant event analysis
Leadership & Management
• Personal & practice
organisation
• Legislative
• Financial
• Leadership & training
Aims
“A competent, caring, reflective
practitioner, able to develop their
career in any branch of dentistry
to the benefit of patients.”
Rationale of foundation programme
• Different clinical environments
• Wide range of clinical cases, and
continuity of care
• Patient types and case complexities
• Introduction to specialised skills
• Different clinical teams
Terminology
• “Demonstrate….to an
appropriate standard.”
• “Describe…in appropriate
detail.”
Supporting competencies
• Extraction of erupted teeth
• Effective management, including extraction where appropriate,
of buried roots, unerupted, impacted, ectopic and
supernumerary teeth
• Effective management of patients with bleeding disorders
• Effective management of benign soft tissue lesions
• Ability to carry out an accurate pre- and post-operative
assessment
• Ability to recognise and manage effectively (including referral
where appropriate) any complications that may arise
The trainee can demonstrate to an appropriate standard:
Supporting competencies 2
The trainee should be able to describe in
appropriate detail:
• The principles and techniques involved in the
surgical placement of dental implants.
The trainee should understand:
• Which instruments to use in different surgical
procedures.
The trainee should be able to carry out an
accurate pre- and post-operative assessment
Overlap with undergraduate curriculum?
For example: Caries management
• Graduate technically competent
• Practitioner completing a foundation
programme would be expected to handle
more complex clinical cases
• More efficient manner
• Co-integration of other competencies e.g
communication, dental team and practice
management issues
How? The MJDF
• Portfolio of Evidence
• Part 1 assessment
• Part 2 assessment
MJDF has three components
Portfolio of Evidence
• Tests knowledge & application of knowledge in clinical and management skill areas
• Completion is a requirement for the award of the diploma
Purpose of the Portfolio
• To give you a contemporary record of activities and thoughts
• To facilitate the gathering of material in order to summarise it for submission
• To help you to reflect on how you have applied your learning in clinical practice
• To facilitate reflection and writing up at the end of the course
• To help you to reflect on the learning process so you can see what was helpful / difficult / took too long / still needs to be completed, etc
• To provide documentary evidence of learning and attainment of clinical skills
Five parts of the Portfolio
• A CV
• Evidence of five core clinical and professional skills
• Evidence of clinical management through presentation of both a:
– Clinical audit or a research project, and a
– Clinical case, case-based discussion or equivalent
• A record of continuing professional development activity, or log of prior experience
• A personal development plan
Personal development plan
• www.pgde-trent.co.uk
• PMETB Workplace Based Assessment Subcommittee
• BDA Clinical Governance Kit
– Strengths
– Weaknesses
– Identify training needs
– Barriers to learning
– How they may be overcome
Five core skills
Must include the three GDC mandatory areas for CPD:
• Infection control
• Medical emergencies
• Dental radiography
Plus two others to select from:• Health & safety in clinical practice
• Record keeping
• Dental teamwork
• Prevention & dental public health
• Law & ethics
Key Skills e-learning package
Evidence of clinical management
1. Audit or research project PLUS
2. Evidence of clinical skills:
• Case presentation OR
• Community or secondary care case presentation or
study OR
• Assessment of workplace-based competencies:
o Mini-clinical evaluation exercises (mini-CEX)
o Multi-source feedback (MSF)
o Directly observed procedural skills (DOPS)
o Case-based discussion (CbD)
Case presentation
Assessment of workplace-based competencies
• See Guide to the MJDF Portfolio of Evidence on MJDF website
• Includes forms, e.g, mini-CEX, DOPS, CbD and MSF evaluation forms
Mini-CEX Evaluation form
Portfolio of Evidence
Assessed locally by an
appropriate assessor
10% sample for QA purposes and
validation
Guide to the portfolio
• General principles & components of the portfolio
• Providing evidence of the core skills
• Layout and presentation
• Questions to ask yourself
• Suggested evidence items & supporting material
• Includes template forms
Download the guide from the MJDF website:
www.fgdp.org.uk/exams/mjdf
or
www.rcseng.ac.uk/fds/mjdf
Part 1 assessment
• One three-hour paper based on the foundation training curriculum
• Assessing knowledge and applied knowledge
• Different formats of:
Multiple choice questions (MCQs) in single best answer (SBA) form – around 70
Multiple short answer questions (MSAs) in extending matching question (EMQ) form – around 10
MCQ Sample 1
Indicate the most appropriate initial radiographic examination
A. Bitewings
B. Bitewings and periapical views of selected teeth
C. Full mouth periapicals
D. Periapicals of the lower incisors
E. Vertical bitewings
3 1 3
1 4 3
A 46-year-old male smoker presents as a
new patient complaining of bleeding gums,
bad breath and a BPE score as shown:
MCQ Sample 2
Which one of the following is most commonly used to bleach teeth?
A. Ethyl chloride
B. Hydrogen chloride
C. Hydrogen peroxide
D. Sodium bicarbonate
E. Sodium hypochlorite
EMQ (MSA) Sample 1
1. A 13-year-old patient designated as having a high caries risk
2. A 15-year-old patient considered to be at moderate risk of future caries
3. A 32-year-old patient still considered as at high risk of future caries
4. A 9-year-old patient at low caries risk
5. A 25-year-old patient at moderate risk of future caries
6. A 38-year-old patient who has had a full coverage crown placed
7. A 27-year-old patient who has had orthograde endodontic treatment to UL6
8. A 7-year-old who has had a vital pulpotomy following trauma to UL1
A. 1 month B. 3 months
C. 6 months D. 12 months
E. 24 months F. 36 months
Match options A to F to the period of time
that should elapse before the next
radiographic review in the clinical
scenarios 1 to 8 below:
EMQ (MSA) Sample 2
Match the skin/nail features A to H with the clinical condition
1 to 5 that you might expect to see:
A. Clubbing
B. Erythematous palms
C. Evidence of widespread
scratching
D. Flattened nails
(koilonychias)
E. Keratotic striations
F. Pitted nails
G. Purpura
H. 'Target' lesions
1. Middle-aged woman with known liver disease
2. 56-year-old psoriasis sufferer
3. Woman with a hypochromic microcytic anaemia
4. Heavy smoker with haemoptysis
5. Patient with a history of gallstones presenting with dark urine and jaundice
Part 2 assessment
• Assessment apx. 3 hours (plus 1 hr prep for SCR)
• Objective structured clinical examination reasoning
(OSCE) and structured clinical reasoning (SCR)
• OSCE – usually 16 stations of 5 min each (approx 2
hours)
• SCR – 1 hour preparation time, then 10 min
discussion for each of five scenarios
Specimen OSCE
Mr Smith has attended your surgery for the removal of a
grossly carious lower molar. He is otherwise fit and well
and taking no regular medication.
You need to take a valid consent from him so that the
procedure could be carried out later the same day or on
another occasion. You have a relevant radiograph as a
prop to help you.
You will be observed by your examiner and marked on
your competency to obtain consent.
Structured clinical reasoning
Assesses candidates ability to:
• Communicate
• Reason
• Evaluate
• Form opinions
• Apply knowledge
SCR scenarios
• Interpret guidelines
• Review literature
• Treatment planning
• Treatment complications
• Complaint management
• Staff training/CPD
SCR overview
Preparation time 1 hour
SCR 1 SCR 2
SCR 3SCR 4
SCR 5
SCR example
Mr D is 40 year old building contractor. He
presents at your practice complaining of pain
from his “upper front teeth”. He smokes and
has an annoying cough. He tells you he
“hates the dentist”.
SCR example cont.d
His BPE scores are:3 2 4
3 3 *
SCR example cont.d
• History
• Communication
• Risk factors
• Special investigations
• Diagnosis
• Treatment plan
The MJDF
A thoroughly modern
assessment
Internationally seen as a
benchmark of excellence
The MJDF
A thoroughly modern
assessment
