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  1. 1. CURRICULUM FORSPECIALIST TRAINING IN PROSTHODONTICSJUNE 2010DEVELOPMENT OF THE CURRICULUMThe revision of the curriculum for Prosthodontics was initiated by the SAC subsequent to recent guidance fromthe General Dental Council (GDC) and its Specialist Dental Education Board (SDEB) on dental specialty training,in line with the principles outlined by PMETB and with the Dental “Gold Guide”.This curriculum has been developed by a working party from the SAC in Restorative Dentistry, chaired by Prof.David Bartlett (curriculum lead for Endodontics, Periodontics and Prosthodontics for the SAC) and includingProf A W G Walls (SAC chair 2007-2010), Professor Jeremy Rees, Dr David Attrill, Mr Sachin Varma and MrStewart Barclay. It has been discussed at the SAC, and has been sent for consultation to the relevantprofessional societies (the British Endodontic Society, the British Society for Periodontology, RestorativeDentistry and the Study of Prosthetic Dentistry) and the Association of Consultants and Specialists inRestorative Dentistry. This consultation process has therefore involved individuals with expertise in curriculumdevelopment, Consultant and Specialist Trainers and trainees. The final version of the curriculum was alsoreviewed by the Joint Committee for Specialist Training in DentistryPURPOSE OF THE CURRICULUMThis curriculum is designed to guide the training and assessment of Specialty trainees in Prosthodontics. Thetraining will produce dentists who will become specialists in Prosthodontics and be included on the GDC’sspecialist list in Prosthodontics. The curriculum is primarily intended for training leading to specialist status inProsthodontics in the UK. In addition, those training in postgraduate (non-specialist) Prosthodontics in the UKor in EU or other countries may wish to compare or calibrate with UK standards for achieving specialist status.Bodies such as the Royal Colleges, Postgraduate Deaneries and education providers may use the curriculum asa guide for assessing individual applications for entry onto specialist lists.CONTEXT OF THE CURRICULUM AND TRAININGThe specialty training period will follow as a continuum a minimum of 2 years basic dental foundation trainingpost qualification as a dentist. Currently dental trainees are expected to complete vocational training duringthis period. It is desirable that during the early training years the individual has experienced work in as manysectors of dental provision as possible.The training will provide a basis for the individual to develop into a life-long learner who is capable of self-reflection and self-directed learning. It will provide the basis of further ongoing development in the field ofProsthodontics at Specialist level.ENTRY REQUIREMENTSA specialty trainee must be registered with the General Dental Council prior to commencement of training. Aminimum requirement for entry to specialty training is 2 years of post-graduate foundation training or 1Prosthodontics Specialty Curriculum June 2010 Review date 2015
  2. 2. equivalent which may include a period of vocational training (VT) and may also include a period of training insecondary care in an appropriate specialist environment.The essential and desirable criteria for specialty trainees will be included in the person specification fortraining posts in the specialty. Evidence of excellence in terms of attributes such as motivation, careercommitment etc will be expected, as will an ability to demonstrate the competences required for entry tospecialty training either by successfully completing a period of agreed dental foundation training or bydemonstrating that those competences have been gained in another way.Markers of completion of a 2 year foundation training period may include MJDF (Membership of Joint DentalFaculties RCS England) or MFDS (Membership of the Faculty of Dental Surgery RCSEd and RCPS Glasg) or MFD(Membership of the faculty of Dentistry RCSI). The SAC feel that successful completion of one of these qualityassured membership diplomas of Royal College Dental Faculties in England, Scotland and Ireland remains auseful indicator that an individual has achieved the necessary level of competence for entry into specialtytraining. However it is recognised that this will not be essential and that candidates may be able todemonstrate such competence in different ways.EQUALITY & DIVERSITYThe SAC in Restorative Dentistry is committed to the principle of diversity and equality in employment,examinations and training. As part of this commitment we are concerned to inspire and support all those whowork with us directly and indirectly.Integral to this approach is the emphasis we place on our belief that everyone should be treated in a fair, openand honest manner. Our approach is a comprehensive one and reflects all areas, of diversity, recognising thevalue of each individual. We aim to ensure that no one is treated less favourably than another on the groundsof ethnic origin, nationality, age, disability, gender, sexual orientation, race or religion. Our intention is toreflect not only the letter but also the spirit of equality legislation.Our policy will take account of current equality legislation and good practice. Key legislation includes:• The Race Relations Act 1976 and the Race Relations Amendment Act (RRAA) 2000• The Disability Discrimination Act 1995 and subsequent amendments• The Sex Discrimination Act 1975 and 1986 and the 1983 and 1986 Regulations• The Equal Pay Act 1970 and the Equal Pay (Amendment) Regulations 1983 and 1986• The Human Rights Act 1998• The Employment and Equality (Sexual Orientation) Regulations 2003• The Employment and Equality (Religion or Belief) Regulations 2003• Gender Recognition Act 2004• The Employment Equality (Age) Regulations 2006.The SAC collects information about the gender and ethnicity of trainees as part of their registration with theirDeanery. This information is recorded nationally by the SAC and statistics are published on an annual basis. 2Prosthodontics Specialty Curriculum June 2010 Review date 2015
  3. 3. These data are collated along with the outcome of annual ARCP reviews for all trainees and the NationalTrainees survey to ensure that the principles of Equality and Diversity for all are being met .CURRICULUM REVIEW AND UPDATINGThis curriculum should be regarded as a “living document”. Formal review updating and revalidation of thecurriculum, its structure and content will be undertaken by the relevant SAC on a 5-yearly rolling cycle.TRAINING PERIODThe usual training period will be 3 years (4500 hours) whole-time or agreed equivalent within the frameworkof a less than full-time training programme. The programme content should be apportioned approximately as60% Clinical, 25% academic and 15% research. This time allocation is flexible and will depend upon thecapacity of the trainees to complete the curriculum to a competent level.MODELS OF LEARNING IN PROSTHODONTICSPractice of this specialty requires a range of skills (thinking, mental visualisation, knowledge, technical, manualdexterity, communication, inter-personal, investigative, management) which will need to be developedsystematically through a number of suitably designed learning opportunities. Trainers will seek whereverpossible to match learning styles with appropriate teaching methods. Depending upon the focus andphilosophy of the host provider, the training may be flexibly delivered through a variety of methods including;structured, taught Masters/Doctorate Degree programme or through a predominantly work-place basedprogramme (speciality practice or hospital based training). In either case, it will remain mandatory for thetrainees to demonstrate certain minimum outcomes in the range and competence in requisite skills.Development of competence will usually take a systematic path progressively building on core skills. This willrequire expert tracking of the learning process and effective guidance in the steps to follow. Trainees mayundertake their learning in the following ways:  Guided theoretical learning during formal and timetabled periods, which may or may not be part of a structured Master’s degree in Prosthodontics. This should be geared towards developing an understanding of the subject by critical appraisal and synthesis of the classical and contemporary literature through individual and group activities, involving discussion and debate;  Validated self-directed and independent study;  Technical skills development through systematic simulation laboratory exercises, with development of a presentation portfolio, reflection and discussion of outcomes through peer presentation and trainer feed-back.  Clinical skills development through supervised clinical practice. Pre-management case discussions may be used to facilitate development of independent decision-making in diagnosis, treatment planning, planning of treatment and treatment execution. Post-treatment case conferences may be used to facilitate group reflection and integration with theoretical knowledge. Clinical log maintenance with contemporaneous reflections from trainee and trainer, including quarterly summary appraisals will provide suitable tracking opportunities, an evidential record, as well as opportunities for guidance of progress in case-load and case-mix;  As the progression from competence through proficiency to mastery involves work-place based training, it will be essential that foundational academic and technical skills development occur in parallel. This will imply an on-going process of assessing clinical performance that involves evaluation not merely of the technical aspects but also the theoretical knowledge underpinning clinical 3Prosthodontics Specialty Curriculum June 2010 Review date 2015
  4. 4. management and development of appropriate professional attitudes and behaviours. It will also mean an appropriate matching of case-mix with ability and skills;  Research exposure through participation in a research project (clinical, experimental or literature research) which is reported formally in a thesis or equivalent written report, or as a manuscript prepared for submission or indeed as a published paper.SUPERVISION AND FEEDBACKSpecialty training will take place in programmes approved by the relevant Post-graduate Deanery. These willbe in a variety of geographic locations and within various healthcare organisations. Training locations may wellevolve as health and social care structures change. Deaneries in which there is training in this discipline willhave a Training Programme Director (TPD) who co-ordinates training together with all designated trainers.Each trainee will have a designated lead trainer (educational supervisor) who will co-ordinate the trainingthroughout the training period. At each training site the Specialty trainee will have a designated trainerappointed as part of the approval of the training programme by the Post-graduate Deanery. The detailedtraining programme description will be available from the TPD in the relevant Deanery.All trainers will be expected to have undergone an appropriate personal education programme as a trainer (forexample “Training the Trainers” or equivalent) and will be expected to maintain their skills as a trainer. Clinicaltrainers should be on the relevant GDC specialist list for their field of expertise. The majority will likely bespeciaists in Prosthodontics or in Restorative Dentistry. Training for trainers is a regular feature of the annualprogramme of the Association and Consultants and Specialists in Restorative Dentistry as well as the educatorsgroups of various specialist societies and from the relevant Surgical Royal Colleges. Attendance at theseexternal opportunities would be regarded as examples of good practice. The trainers will be subject to regularanonymous peer review by the trainees for whom they are responsible. Any deficiencies in training will beidentified and addressed by the Training Programme Director and the relevant individuals from the Post-graduate Deanery.In the early stages of training, trainees will be closely assessed to determine their competence base. The levelof supervision initially will be close to ensure patient safety and allow the gauging of ability and potential forindependent progression. As supervised tracking shows development of competence, the level of supervisionmay be tapered down in proportionate measure, ultimately leading to independent practice within thetraining period such that towards the end, the trainee will be primarily log-monitored for proceduresappropriate to the competencies of the individual trainee.The trainees should be exposed to a variety of philosophies within the discipline through multiple clinicalsupervisors who are based within a secondary / tertiary care environment as well as those providing specialistpractice in primary care. This will inevitably require an organised approach in coordinating and correlatingprogress tracking from the different supervisory sources.Flexibility should be encouraged for the provision of training in a variety of approved settings, including acuteteaching hospitals, community clinics and NHS/Private practice, particularly during the later stages of theprogramme.FEEDBACK ON LEARNINGSpecialty trainees will have a learning needs assessment undertaken by their trainers at the beginning of theprogramme, to identify areas of previous experience and training. There will be a learning contract agreed foreach training location and period, which will identify areas for learning and projects to be undertaken towards 4Prosthodontics Specialty Curriculum June 2010 Review date 2015
  5. 5. specified outcomes. Specialty Trainees will have 6 monthly appraisals which will include self-reflection onprogress as well as trainer assessment leading to development of a personal development plan producingagreed time-based actions on the basis of each appraisal. There is standard paperwork for use in appraisal.Attitudinal learning outcomes will be measured by the behaviour demonstrated relevant to that attitude.Behaviour is more readily measured in an objective manner than the underlying attitude.Assessment of competence will be collated by multiple assessment methods through multiple assessors.Assessment methods will include mini clinical examination (mini-CEX), direct observation of procedural skills(DOPS), Case-based discussion (CBD), log book records (including regularly produced mini case reports) Multi-source Feedback (MSF) and reflective summaries. These systems will provide a regular review of progresstowards desired outcomes and give a record of progress over time. Appraisal and assessment will in turnadvise the Training Programme Director to make a recommendation to the Deanery ARCP (Annual Review ofCompetence Progression). This will in turn lead to confirmation of satisfactory progress or the need forincreased supervision or increase in proposed length of training. Satisfactory progress in the / ARCP processand success in an exit assessment by examination is required before award of Certificate of Completion ofSpecialty Training (CCST).RECORD OF TRAININGSpecialty trainees will need to keep a record of training through the training period in a log book to inform theARCP process and will need to keep copies of all ARCP paperwork. This will help trainers where there may bemovement between training locations to be informed on an individual’s current progress towards outcomedevelopment. A rolling PDP facilitating movement towards the desired outcomes will give a readily accessiblesummary (as above). The log will include treatment and case-mix summaries, outcomes and reflection bytrainee and trainer on each major project. A record of all appraisals will be kept alongside the log book. Duringtraining all possibly relevant documents will be included to facilitate the ARCP process and moves betweentrainers and to inform the ARCP process. Keeping the log book and portfolio of cases completed and up to dateis a trainee responsibility.TRAINING LOCATIONS AND ORGANISATION OF TRAININGSpecialty training will take place in programmes approved by the Postgraduate Dental Deans. Currently, mosttraining courses are established within Universities and Dental Hospitals and are linked with a Masters levelqualification, however, completion of a masters level qualificatin will not be a requirement for satisfactorycompletion of training.A Training Programme Director appointed by the Postgraduate Dental Dean will co-ordinate the programmeand its formal management. Each trainee will have separate educational supervisors and clinical trainers whowill organise and administer the day-to-day training. The programmes will be quality managed in line with theDental Gold Guide. The local Postgraduate Dental Dean will be responsible for all aspects of qualitymanagement of the training.SUMMATIVE EXAMINATION: SPECIALTY MEMBERSHIP DIPLOMA IN PROSTHODONTICSSpecialty trainees are required to be successful in the relevant Specialty Membership in Endodontics beforebeing awarded their CCST. The award of a CCST is made by the GDC on the recommendation of the Deanery in 5Prosthodontics Specialty Curriculum June 2010 Review date 2015
  6. 6. which the training programme is taking place. The regulations for this assessment are available from the 1examining body.CONTENT OF LEARNINGCURRICULUM MILESTONESThese milestones will be used to record how the trainee moves from the “knows / knows how” to “shows” and“shows how” as training develops. These are based on the principles developed by Miller in 1961.Attitudes will be measured by the behaviour demonstrated relevant to that attitude.Level less well developed  No or very limited knowledge and experience in subject area  Attitude / value not well developedLevel 1  Knowledge in subject area, a little practical experience and some skill  Attitude / value developingLevel 2  More extensive knowledge in subject area, and more practical experience  Still requires supervision when working in subject area  Attitude / values well developedLevel 3(Ready for completion of training)  Ability to work in area unsupervised  Knowledge in subject area as expected of a Specialist in Prosthodontics  Skill in subject area as expected of a Specialist in Prosthodontics  Performance of tasks and approach to tasks as expected of a Specialist in Prosthodontics  Attitudes as expected of a Specialist in ProsthodonticsAppropriate documentation to record acquisition of these milestones is given in Annex 1NB Generally these levels will correspond with number of years training undertaken. However, this will notalways be the case as some specialty trainees will enter the programme with extensive experience in someareas.AIMS OF SPECIALTY TRAINING IN PROSTHODONTICS1 Note the specialty fellowship examinations from RCS Ireland whilst assessing competence in their identifieddiscipline are NOT acceptable to the GDC in terms of assessing completion of training and eligibility for a CCSTin this specialty. 6Prosthodontics Specialty Curriculum June 2010 Review date 2015
  7. 7. 1. The specialty trainee will exhibit an understanding and a breadth and depth of knowledge of Prosthodontics. 2. The specialty trainee will acquire and become proficient in the skills required for specialist practice with an emphasis on practical skills, treatment planning, disease prevention, and provision of specialist care in either primary or secondary care settings. 3. The specialty trainee will be proficient in a full range of technical and clinical skills in Prosthodontics to undertake treatment planning, disease prevention, and provision of specialist care in either primary or secondary care settings. 4. The specialty trainee will acquire and demonstrate attitudes necessary for the achievement and delivery of the highest standards of Prosthodontics care, in relation to the oral health needs of populations, the needs of patients under treatment and to his or her own personal development. 5. The specialty trainee will develop the ability to collect relevant clinical information (biological, technical, psychological, social) from patients’ history, examination and special tests and to integrate and analyse it to identify the nature of their problem, where necessary using differential and provisional lists, with further investigation and analysis to make a definitive diagnosis of the problem(s). 6. Develop sufficient familiarity with available treatment options in order to discuss with patients and make an appropriate choice (if necessary in conjunction with other specialists) and to formulate an overall integrated plan of management for each patient. 7. Develop the ability to systematically plan the management of a clinical problem and the necessary practical and surgical skills . 8. Develop the ability to communicate effectively and professionally with referring clinicians, in order to coordinate the efficient delivery of care. 9. Develop sufficient understanding of research to critically assess classical or new research work. 10. An ability and motivation to maintain the responsibilities related to continuing professional development and using a life-long learning philosophy. 11. Full knowledge and practice of clinic governance issues. 12. An appropriate attitude and understanding of ethical and societal issues and the place of their speciality in the overall healthcare spectrum. 13. The specialty trainee will maintain the standards of practice in dentistry and Prosthodontics as determined by the GDC.OUTCOMES OF SPECIALTY TRAINING IN PROSTHODONTICSUpon completion of the programme a typical Specialty trainee will be able to:1) Knowledge and Understanding a) Demonstrate understanding of the anatomy and physiology of the oral and peri-oral tissues b) Demonstrate understanding of the aetiology pathobiology and clinical presentation of diseases of the oral and peri-oral tissues c) Demonstrate understanding of general and clinical epidemiology of oral diseases d) Demonstrate understanding of biomaterial science relevant to prosthodontics e) Demonstrate understanding of the impact of systemic diseases on oral tissues and of oral disease on systemic health f) Demonstrate understanding of the behavioural, clinical and technical procedures involved in the treatment of patients requiring prosthodontic care g) Communicate individually with patients and other professionals and in general educational and professional settings 7Prosthodontics Specialty Curriculum June 2010 Review date 2015
  8. 8. h) Show evidence of the ability to assess research2) Intellectual Skills a) Demonstrate a broad and sound understanding of the evidence base in Prosthodontics b) Show professional judgement to implement clinical solutions in response to clinical problems by developing an evidence based treatment plan and taking an holistic approach to solving problems and designing treatment plans c) Demonstrate the ability to critically assess scientific papers and available evidence such as guidelines using a variety of information sources d) Evaluate critically the scope and limitations of the various techniques used in Prosthodontics balancing the risks and cost benefits of treatment demonstrating self-direction and autonomy e) Develop an integrated insight into how the development and impact of their knowledge and skills is of value and relevance to the workplace f) Appraise systematically current evidence in Prosthodontics and appreciate how research activity can inform practice g) Demonstrate the ability to sustain a critical argument in writing and through oral presentations h) Demonstrate a sound understanding of the importance of hypothesis-setting and the design of suitable projects to address questions relating to the practice of Prosthodontics3) Practical Skills a) Perform all appropriate clinical examinations proficiently, collecting biological, psychological and social information needed to evaluate the oral and related medical conditions for all patients b) Provide clinical care to the highest ethical and technical standards in line with current knowledge and with the full and valid consent of patients c) Demonstrate clinical proficiency in the delivery of preventive and interventional care as part of a holistic, comprehensive treatment plan d) Recognise and manage behavioural and related social factors which affect oral health e) Use clinical information to implement strategies that facilitate the delivery of oral health f) Co-ordinate overall treatment and care of patients and appreciate when it is appropriate to refer to a specialist in another area or a dental care professional g) Demonstrate the communication skills necessary to support patients and to translate changes in clinical practice informed by clinical audit and research to the commissioners of oral healthcare through critical analyses of published data from clinical and laboratory-based studies in Prosthodontics4) Transferable Skills a) Become an effective and efficient leader of a multi professional team practicing Prosthodontics b) Undertake audit, peer review and continuing professional development guiding the learning of others c) Learn independently in familiar and unfamiliar situations with open-mindedness and in a spirit of critical enquiryASSESSMENTThe purpose of training is to promote patient safety by working to ensure that specialists have achieved theappropriate learning outcomes. The Royal Colleges and partner organisations in Restorative Dentistry aims topromote excellence in the practice of restorative dentistry and to be responsible for maintaining standardsthrough training, assessments, examinations and professional development.The purpose of the assessment system follows the guidelines of Surgical Royal Colleges (UK) and the principleslaid down by the PMETB (Principles for an assessment system for postgraduate medical training). The purposesof the assessments include: 8Prosthodontics Specialty Curriculum June 2010 Review date 2015
  9. 9.  Indicate suitability of choice at an early stage of the chosen career path  Indicate the capability and potential of a trainee through tests of applied knowledge and skill relevant to the specialty  Demonstrate readiness to progress to the next stage(s) of training having met the required standard of the previous stage  Provide feedback to the trainee about progress and learning needs  Support trainees to progress at their own pace by measuring a trainees capacity to achieve competencies for their chosen career path  Help to identify trainees who should change direction or leave the specialty  Drive learning demonstrated through the acquisition of knowledge and skill  Enable the trainee to collect all necessary evidence for the Annual Review of Competence Progression (ARCP)  Gain Membership of one of the Surgical Royal Colleges (UK)  Provide evidence for the award of the CCST  Assure the public that the trainee is ready for unsupervised professional specialist practice.Trainees will be assessed in a number of different ways during their training. Satisfactory completion of allassessments and examinations will be monitored as part of the ARCP process and will be one of the criteriaupon which eligibility to progress will be judged. A pass in the Specialty Membership Examination inProsthodontics is required as part of the eligibility criteria for the award of the CCST in Prosthodontics.Assessment of Trainees will take two forms:WORKPLACE-BASED ASSESSMENTSThe principal form of continuous assessment of progress and competence will be workplace-basedassessments throughout the entire duration of training. The principle of workplace-based assessment is thattrainees are assessed on work that they are doing on a day-to-day basis and that the assessment is integratedinto their daily work.The assessment process is also dependent upon the trainee, who should identify opportunities for assessmentthroughout their training. Assessments, if possible by a range of assessors, should cover a broad range ofactivities and procedures appropriate to the stage of training.Some of the assessment methods currently available are:  Directly observed practical skills (DOPS) (5 satisfactory outcomes will normally be required per year)  Case-based discussion (CbD) (5 satisfactory outcomes will normally be required per year)  Mini clinical evaluation exercises (Mini-CEX) (5 satisfactory outcomes will normally be required per year)  0 Multi-source feedback (MSF) (annual). This must involve formal 360 feedbacks at least twice during the period of training between times, feedback from trainers for an annual assessment by the Educational Supervisor to feed into the RITA/ARCP process  Critical Incident Review (to be used as and when appropriate and recorded in the trainees log book)  It is also expected that trainees will participate in individual or group tutorials which may also involve a degree of assessment and will take a full part in both audit and clinical governance activity within the training units. These may inform trainers when feeding back to the Educational Supervisor / Programme Directors as part of the MSF process. 9Prosthodontics Specialty Curriculum June 2010 Review date 2015
  10. 10. EXAMINATIONFormal completion of training will be marked by satisfactory summative assessment and success in theSpecialty Membership Examinations in Prosthodontics organised by the Faculty of Dental Surgery of the RoyalCollege of Surgeons of Edinburgh and jointly by the Dental Faculties of and the Royal College of Surgeons of 2England and the Royal College of Physicians and Surgeons of Glasgow.The assessment methods are blueprinted to the curriculum in the tables that follow. It is not intended thateach component of the curriculum is assessed by each method. The assessment methods are indicative of themethods that may be used for each subject area, and should be applied as appropriate to the stage of trainingand circumstances of the training environment. Trainees should note that the Royal College examinations arewide ranging and most subject areas covered in the curriculum may be formally examined.LEARNING OUTCOMESTables 1-16 that follow define in detail the domains of competence and the related learning outcomes forProsthodontic training.2 Note the specialty fellowship examinations from RCS Ireland whilst assessing competence in their identifieddiscipline are NOT acceptable to the GDC in terms of assessing completion of training and eligibility for a CCSTin this specialty. 10Prosthodontics Specialty Curriculum June 2010 Review date 2015
  11. 11. 1. EXAMINATION AND DIAGNOSIS Upon completion of the subject the trainee should be able to:Objective Knowledge of Skills Attitudes Teaching and learning Assessment methods Carry out a thorough and Describe:  Complete a thorough  Embrace a holistic,  Workplace (clinical)  DOPS appropriate assessment and examination of the patient’s: unbiased and experience with examination of the patient, their  Relevant biology, unprejudiced appropriate trainers;  CBD dental, pulpal, periradicular, anatomy, physiology of o oral mucosae and related approach; specific new patient normal and abnormal structures  Patient surveys periodontal, oral and peri-oral clinics to experience tissues in relation to the intra- and extra-oral  Recognise importance exposure to a wide range o periodontium  Staff feedback from presenting complaints of the structures and tissues; of biological aspects of of presenting conditions; interdisciplinary patient, arriving at an the oral and peri-oral  Pain physiology and o dental hard tissues planning and case appropriate diagnosis of the structures  Attend trainee seminars clinical presentations of review sessions. condition from the information  and make appropriate within department; relevant oro-facial  Recognise urgency of provided and examination and diagnoses  SPECIALTY conditions; patients requiring  Journal club review; investigations undertaken; MEMBERSHIP  Take into account any immediate assessment  Sensitivity and and treatment, and  Independent study; Clearly appreciate the conditions systemic factors likely to have specificity of diagnostic differentiates from confounding diagnosis of a bearing on the above. tests;  Attend and prosthodontic problems non-urgent. present/actively engage in  Complete a thorough  Dental, medical and  Recognise own limits inter-disciplinary examination of any existing social history factors and chooses treatment planning and prosthesis and related tissues likely to be relevant to appropriately when to case review sessions; and structures and be able to the presenting condition ask for help. evaluate the biological and and its previous  Attendance at suitable aesthetic quality of the management; courses and meetings; prosthesis  The influence of peri-  Use all appropriate oral structures on the investigations (e.g. appearance of the radiographic, sensitivity and patient and their 11Prosthodontics Specialty Curriculum June 2010 Review date 2015
  12. 12. potential influence on vitality tests, haematological function and stability of and microbiological tests and the dentition or any appropriately articulated prostheses. study casts) to diagnose oral problems 12Prosthodontics Specialty Curriculum June 2010 Review date 2015
  13. 13. 2. DEVELOPMENT OF TREATMENT STRATEGIES AND PLANS IN PROSTHODONTICS Upon completion of the subject the trainee should be able to:Objective Knowledge of Skills Attitudes Teaching and learning Assessment methods Devise strategies and plans Describe:  weigh options against each other  Embrace a caring and  Workplace (clinical)  DOPS based on the likely prognosis and succinctly describe pros and patient-centred experience with and outcomes of the various  Dental, medical and cons of each; approach to treatment appropriate trainers  CBD treatment options, relating social history factors planning.  Communicate the facts in terms  MSF: dentists, this to prognosis without relevant to proposed  Attend trainee seminars appropriate to the intellectual patients and other treatment and establishing a management;  Express confidence, within department capacity of the patient; insight and empathy in team members resultant priority and  Dental materials,  Communicate clearly and formulating and  Attendance at suitable sequence of treatment while  SPECIALTY equipment and succinctly the impact of oral status presenting strategies courses considering the relevant MEMBERSHIP technical requirements and proposed treatment on quality & plans to patients ethical and fiscal issues  Attendance at suitable to achieve each of life to the patient; and colleagues. treatment goal; meetings Develop a treatment strategy  Advise on the possible and in conjunction with the  Present unwelcome  Current best evidence probable outcomes of the  Independent study patient producing a plan or information and for effectiveness of treatment options, as well as the plans according to their needs manage unrealistic need for future supportive care, various treatment patient expectations. and preferences, including prevention and maintenance; modalities; future need for further  Discuss the impact on proposed  Recognise limits of corrective or supportive  Prognostic and risk treatment of constraints of the knowledge and therapy. factors for various political and financial systems; experience. modalities;  Delineate strategies and plans  Demonstrate ethical according to the skills of other and non-self- clinicians involved in the care of interested outlook in the patient; treatment planning  Explain, motivate engage, assure and patient and assess the patient’s communication; participation and compliance in 13Prosthodontics Specialty Curriculum June 2010 Review date 2015
  14. 14. their own oral care.  Treat all patients with dignity and respect 1. 14Prosthodontics Specialty Curriculum June 2010 Review date 2015
  15. 15. 3. HEALTH PROMOTION, PREVENTION OF DISEASES INCLUDING INFECTION CONTROL Upon completion of the subject the trainee should be able to:Objective Knowledge of Skills Attitudes Teaching and learning Assessment methods Advise each patient on Describe:  Communicate in lay terms Recognise:  Workplace (clinical)  MCQs, appropriate preventive appropriate to the intellectual experience with methods especially in relation  Relevant biology, capacity of the patient  the impact of the appropriate trainers  OSCE, to oral hygiene, smoking anatomy, physiology, patient’s oral and cessation and home use of pathology and  Communicate with the patient general health status  Attend trainee seminars  DOPs, preventive chemical agents microbiology on the impact of their oral and the proposed within department status and the proposed advice advice on their quality  MSF: dentists, patients Be able to use and deploy all  infection control on their quality of life of life  Attendance at suitable and other team methods to prevent occurrence measures in dentistry courses members and recurrence of dental and the value of  Advise on the possible  the need for appropriate vaccinations outcomes of non-compliance supportive care,  Attendance at suitable  SPECIALTY diseases in individual patients for self and other staff and the need for supportive prevention and meetings MEMBERSHIP Develop a care strategy in care, prevention and maintenance  Dental materials,  Independent study conjunction with the patient, maintenance producing a plan according to equipment and  the need to work with their needs and preferences technical requirements  use all methods and other clinicians and to achieve this technologies to prevent DCPs in provision of Advice other health care infection during treatment the treatment and of professionals on methods and procedures, between patients skill base and role and technologies to prevent and staff and during transport in achieving the end infection during dental of materials and prostheses result. treatment procedures, between the laboratory and between patients and staff and the clinic during transport of materials and prostheses between the laboratory and the clinic 15Prosthodontics Specialty Curriculum June 2010 Review date 2015
  16. 16. 4. INTERDISCIPLINARY INTERFACES Upon completion of the subject the trainee should be able to:Objective Knowledge of Skills Attitudes Teaching and learning Assessment methods To understand the importance Describe:  Use appropriate knowledge  Integrates knowledge,  Workplace (clinical)  ARCP Case reports and implications of the inter- and clinical techniques to and practical expertise experience with relationship between  Relevant biology, diagnose related clinical in the assessment of appropriate trainers  CBD Prosthodontics and other anatomy, physiology, problems from first principles; multidisciplinary cases; pathology and  Appropriate range of  DOPS / Mini -CEX – to clinical disciplines, particularly microbiology, including  Co-ordinate management of  Acts on limitations of clinical assessments be developed periodontics and endodontics appropriate patients requiring endodontic knowledge and  Attend trainee seminars  MSF Carry out periodontics and antimicrobial and/or periodontal treatment practical experience in endodontics at the level of a prescription where before, during and after the assessment and within department  SPECIALTY skilled general dental necessary; prosthodontic treatment; management of MEMBERSHIP  Attendance at suitable practitioner; interdisciplinary cases;  the evidence and  Demonstrate treatment courses Assess the endodontic and mechanisms by which planning and management  Acts ethically in  Attendance at suitable periodontic status of teeth oral microorganisms skills in dealing with medically seeking the best meetings relevant to their potential use may be dispersed and compromised and special interdisciplinary care in support of a prosthesis cause disease in distant needs patients; for patients  Independent study sites;  Demonstrate treatment  the factors which make planning and practical skills a tooth unrestorable; necessary for restoring endodontically treated teeth  the adverse effects of using a range of techniques; treatment procedures on tooth structure;  Demonstrate the ability to assess when the input of  occlusion and its specialist colleagues is required influence on periodontic in the planning and execution practice 16Prosthodontics Specialty Curriculum June 2010 Review date 2015
  17. 17.  the biological rationale of integrated care ( and indications for  Apply knowledge of occlusion dental implants; in the assessment and  the procedures for management of teeth. placement, restoration  Communicate clear treatment and maintenance of plans to colleagues including dental implants; other dental specialists,  Dental materials, primary care practitioners and equipment and DCPs, where appropriate technical requirements to provide relevant treatment 17Prosthodontics Specialty Curriculum June 2010 Review date 2015
  18. 18. 5. FIXED PROSTHODONTICS Upon completion of the subject the trainee should be able to:Objective Knowledge of Skills Attitudes Teaching and learning Assessment methods Plan and provide all types of Describe:  Show specialist level skill in the Recognise:  Workplace (clinical)  ARCP Case reports fixed dental prostheses for planning of fixed prosthodontics experience with appropriate clinical  relevant biology,  The relevance and appropriate trainers  CBD anatomy, physiology,  Show competency at a specialist inter-relationship of circumstances pathology, microbiology level for preparation of teeth for fixed prosthodontic  Appropriate range of  DOPS direct and indirect restorations Understand and use the and technical treatment on overall clinical cases for  Mini-CEX appropriate techniques, requirements in  Select the appropriate material for restorative care and observational and materials and technologies provision of such direct and indirect restorations long term personal treatment  Patient survey available for all types of fixed prostheses maintenance and  Manage soft tissues atraumatically  Attend trainee seminars dental prostheses function  SPECIALTY  current and seminal so as to obtain accurate within department MEMBERSHIP Understand the laboratory literature on indications impressions or otherwise assist in  The relevance of requirements for restorations for, success / failure provision of excellent restorations fixed prosthodontic  Attendance at suitable and show effective criteria and treatment on pulpal courses  Obtain accurate impressions for communication with laboratory biomechanical manufacture of all types of and periodontal  Attendance at suitable technicians implications of such laboratory restorations and health and pathology meetings restorations prostheses and patient well- provide treatment plans for being and self-  Independent study primary care practitioners in  dental materials,  Accurately record the occlusion esteem relation to provision of fixed equipment and including competency in using prosthodontic treatment techniques to provide facebow and articulation and understand when these techniques relevant treatment and Monitor and evaluate the are applicable the response of the effectiveness of fixed dental tissues to this  Provide appropriate provisional prosthodontic treatment treatment restorations for intermediate stages of treatment 18Prosthodontics Specialty Curriculum June 2010 Review date 2015
  19. 19.  Fit restorations using appropriate cements ensuring that appearance, occlusion and function are in harmony with the remaining dentition and patient’s wishes 19Prosthodontics Specialty Curriculum June 2010 Review date 2015
  20. 20. 6. REMOVABLE PROSTHODONTICS Upon completion of the subject the trainee should be able to:Objective Knowledge of Skills Attitudes Teaching and learning Assessment methods Plan and provide dentures with Describe:  Show a specialist level skill in Recognise:  Workplace (clinical)  ARCP Case reports the appropriate clinical and the planning of removable experience with technical procedures.  relevant biology, prosthodontics  The relevance and appropriate trainers  CBD anatomy, physiology, inter-relationship of Understand the materials and pathology, microbiology  Carry out appropriate tooth removable  Appropriate range of  DOPS technologies available for all and technical preparations or pre-prosthetic prosthodontic clinical cases for  Mini –CEX types of removable dental requirements in tissue management to obtain treatment to overall observational and prostheses provision of such accurate impressions or restorative care and personal treatment  Patient survey prostheses otherwise assist in provision of long term Understand the laboratory excellent restorations maintenance and  Attend trainee seminars  SPECIALTY requirements for restorations &  current and seminal function within department MEMBERSHIP show effective communication literature on indications  Record accurately the with laboratory technicians for, success / failure appropriate occlusal  The relevance of  Attendance at suitable criteria and relationship, including the use removable courses undertake procedures necessary biomechanical of facebows or equivalent prosthodontic to extend lifespan of prostheses  Attendance at suitable implications of such technologies where treatment to meetings restorations appropriate mucosal and provide treatment plans for periodontal health  Independent study primary care practitioners in  dental materials,  Fit restorations ensuring that and pathology and relation to provision of equipment and appearance, occlusion and patient well-being removable prosthodontic techniques to provide function are in harmony with and self-esteem treatment relevant treatment and the remaining dentition, facial the response of the tissues and patient’s wishes Monitor and evaluate the dental tissues to this effectiveness of prosthodontic treatment treatment 20Prosthodontics Specialty Curriculum June 2010 Review date 2015
  21. 21. 7. IMPLANTS Upon completion of the subject the trainee should be able to:Objective Knowledge of Skills Attitudes Teaching and learning Assessment methods Formulate appropriate Describe:  Show a specialist skill in the Recognise:  Workplace (clinical)  ARCP Case reports treatment plans for implant choice and execution of experience with retained or supported fixed or  relevant biology, appropriate techniques for all  The relevance and appropriate trainers  CBD removable prostheses, while anatomy, physiology, stages of the planned inter-relationship of including attendance at working as part of a multi- pathology, microbiology dental implant  DOS treatment in conjunction with appropriate disciplinary team to achieve and technical other specialists/ dental care treatment on overall multidisciplinary clinics  Mini -CEX optimum outcomes for the requirements in professionals as a multi- patient care and long and theatre sessions patient provision of dental term maintenance disciplinary team when  MSF/patient survery implants managing the patient. and function and on  Appropriate range of To co-ordinate a treatment patient well-being clinical cases for  SPECIALTY plan, with other relevant  current and seminal and self-esteem observational and MEMBERSHIP specialists, aimed at replacing literature on indications personal treatment teeth with implants. for, success / failure  The cost implications Plan appropriate radiographic criteria and biological of treatments  Attend trainee seminars images implications of provision involving implants within department of dental implants and guidelines Complete surgical and applicable to  Attendance at suitable radiographic guides to aid  surgical techniques for provision of such courses planning of number, position implant placement, treatment and angulation of fixtures healing and exposure  Attendance at suitable meetings Construct and deliver  biological benefits of provisional and definitive and indications for  Independent study implant-retained or -supported their use prostheses  principles and practice Use appropriate clinical skills of prevention of 21Prosthodontics Specialty Curriculum June 2010 Review date 2015
  22. 22. to restore implant fixtures diseases relating to implant structures Monitor and evaluate the effectiveness of implant rehabilitation 22Prosthodontics Specialty Curriculum June 2010 Review date 2015
  23. 23. 8. MANAGEMENT OF TEMPOROMANDIBULAR DISORDERS (TMD) Upon completion of the subject the trainee should be able to:Objective Knowledge Skills Attitudes Teaching and learning Assessment methods Diagnose oral parafunction Describe:  Communicate effectively and Recognise:  Workplace (clinical)  ARCP Case reports and other factors in the empathically with patients to experience with development of dysfunction  relevant biology, identify potential aetiological  The need for empathy appropriate trainers  CBD of mandibular movements anatomy, physiology, factors and signs and and patient counselling including attendance at and the TMJs. pathology and radiology skills  DOPS symptoms of TMD appropriate in provision of care and multidisciplinary clinics Provide behavioural advice  The relevance of  Mini -CEX advice for TMD  Show a high degree of skill in and theatre sessions for the management of these the choice and execution of treatment of TMD on  MSF/patient survery problems  current and seminal appropriate techniques for overall patient care and  Appropriate range of literature on diagnosis treatment in conjunction with long term function and clinical cases for  SPECIALTY Construct appropriate and management of other specialists/ dental care on patient well-being observational and personal MEMBERSHIP occlusal appliances for the these disorders professionals managing the treatment diagnosis and treatment of these problems patient  different treatments  Attend trainee seminars available for TMD and communicate and work with within department colleagues on the recognise limitations multidisciplinary (jaw exercises,  Attendance at suitable management of these interocclusal appliances, courses problems registration techniques, occlusal adjustment,  Attendance at suitable Monitor and evaluate the conformative and meetings effectiveness of treatment reorganised approaches regimes  Independent study to oral reconstruction, psychological approaches) 23Prosthodontics Specialty Curriculum June 2010 Review date 2015
  24. 24. 9. TOOTH WEAR (TOOTH SURFACE LOSS) Upon completion of the subject the trainee should be able to:Objective Knowledge of Skills Attitudes Teaching and learning Assessment methods Take an appropriate Describe:  Show a specialist level skill Recognise:  Workplace (clinical)  ARCP Case reports history to discover the in the planning of patients experience with aetiological factors  Relevant anatomy, with tooth wear  The relevance and inter- appropriate trainers  CBD involved in tooth wear physiology, pathology, relationship of adhesive microbiology and  Show competency at a and conventional  Appropriate range of  DOPS Understand and use the technical requirements in specialist level for restorations in the clinical cases for  Mini-CEX appropriate techniques, the management of tooth preparation of teeth for prosthodontic treatment observational and materials and technologies wear direct and indirect of tooth wear personal treatment  MSF/patient survey available to manage tooth restorations wear  Current and seminal  The effect of  Attend trainee seminars  SPECIALTY MEMBERSHIP literature on the aetiology  Select the appropriate prosthodontic treatment within department Understand the laboratory and preventive material(s) for direct and of tooth surface loss on requirements for management of tooth indirect restorations pulpal and periodontal  Attendance at suitable restorations and show wear health and pathology courses effective communication  Accurately record the and patient well-being  Dental materials, occlusion including  Attendance at suitable with laboratory technicians and self-esteem equipment and competency in using meetings Provide treatment plans techniques to provide facebow and articulation  Independent study for primary care relevant treatment and and understand when practitioners in the the response of the these techniques are management of tooth dental tissues to this applicable wear treatment  Provide appropriate Monitor and evaluate the provisional restorations effectiveness of treatment in tooth wear  Fit restorations using appropriate adhesives or 24Prosthodontics Specialty Curriculum June 2010 Review date 2015
  25. 25. cements ensuring that appearance, occlusion and function are in harmony with the remaining dentition and patient’s wishes 25Prosthodontics Specialty Curriculum June 2010 Review date 2015
  26. 26. 10. AESTHETIC DENTISTRY Upon completion of the subject the trainee should be able to:Objective Knowledge of Skills Attitudes Teaching and learning Assessment methods Plan and provide all types Describe:  Show a specialist level skill Recognise:  Workplace (clinical)  ARCP Case reports of dental procedures for in the planning of smile experience with managing changes in  Relevant dental anatomy design  The relevance and inter- appropriate trainers  CBD tooth colour and shape and tooth proportion relationship of fixed involved in smile design  Show competency at a prosthodontic treatment  Appropriate range of  DOPS Understand and use the specialist level for on overall restorative clinical cases for  Tooth whitening  Mini-CEX appropriate techniques, preparation of teeth for care and long term observational and materials and techniques for vital and direct and indirect maintenance and personal treatment  MSF/patient survery technologies available for non-vital teeth restorations function altering tooth colour and  Attend trainee seminars  SPECIALTY MEMBERSHIP  Use of micro- and macro-  Select the appropriate  The potential effects of within department proportion abrasion material for direct and veneers and crowns on Understand the indirect restorations pulpal and periodontal  Attendance at suitable  Use of gingival masks to courses laboratory requirements health and pathology manage gingival recession  Provide appropriate for restorations and and patient well-being provisional restorations  Attendance at suitable show effective  Use of direct composite and self-esteem for intermediate stages of meetings communication with layering techniques for laboratory technicians treatment managing alterations in  Independent study tooth colour and  Fit restorations using Provide treatment plans morphology appropriate adhesives or for primary care practitioners in relation cements ensuring that  Use of veneers for to smile design appearance, occlusion and managing alterations in function are in harmony tooth colour and Monitor and evaluate the with the remaining morphology effectiveness of dentition and patient’s 26Prosthodontics Specialty Curriculum June 2010 Review date 2015
  27. 27. treatment wishes 27Prosthodontics Specialty Curriculum June 2010 Review date 2015
  28. 28. 11. PAIN CONTROL, ANALGESIA, SEDATION AND ANAESTHESIA Upon completion of the subject the trainee should be able to:Objective Knowledge of Skills Attitudes Teaching and learning Assessment methods Provide appropriate pain and Describe:  Confidently and efficiently Demonstrate:  Workplace (clinical)  ARCP Case reports anxiety control for patients assess patients presenting with experience with attending for non-surgical  The basic and clinical painful conditions.  An empathetic and appropriate trainers  CBD and surgical treatment on a science of acute and holistic approach to including attendance at planned or emergency basis chronic peri-oral pain  Appropriately manage the use patients attending  DOPS appropriate of all standard local anaesthetic with pain conditions multidisciplinary clinics Diagnose and provide  The mechanisms of  Mini -CEX and analgesic regimes and theatre sessions appropriate emergency failed local anaesthesia  A non-judgemental dental treatment for the relief  Identify patients requiring approach to the  Appropriate range of of acute pain  Primary and specialist or interdisciplinary management of clinical cases for supplementary care for the management of patients with long- Advise on appropriate peri- observational and techniques for local non-dental and chronic pain standing and difficult- operative analgesia personal treatment anaesthesia of the pulp conditions. to-diagnose pain Recognise the need for inter-  Attend trainee seminars  Procedures for the  Confidence to disciplinary care in the within department emergency care of acute withhold operative management of pain and dental pain and sepsis dental interventions in  Attendance at suitable anxiety conditions the absence of a clear courses  Pharmacology and dental diagnosis therapeutics related to  Attendance at suitable analgesic use  Openness in the meetings management of  Features of non-dental  Independent study patients without a and chronic pain clear pain diagnosis conditions 28Prosthodontics Specialty Curriculum June 2010 Review date 2015