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Dental education is currently under scrutiny in order to most appropriately address community needs for the new millennium. Educational outcomes need to include a commitment to life-long learning, and an emphasis on professional ethics and moral responsibility. These needs are supported by new forms of information delivery with a focus on the electronic media, by student centred and self-directed coursework, and by clinical stimulation. Additionally, at the University of Sydney, selection will follow a first degree. This will allow candidates time for an informed decision to be made for their future professional career and for a period of experience in the tertiary education system.

This phenomenological research study investigated experiences and concerns that music therapy students have during their preclinical or practicum experiences. Interviews with students were intended to lead to an understanding of these experiences as the students perceived them. Eight students enrolled in undergraduate music therapy practica participated in open-ended interviews over the period of a year, with most students being interviewed 3 times. Six areas of interest emerged from the analysis: challenges encountered by students, means of dealing with challenges, involvement with clients, areas of learning, supervision issues, and structure of practicum. These areas and subcategories under them are presented along with transcriptions from the interviews to illustrate the points. Implications of the research for education and clinical training are discussed.

Marriage and family therapy programs need to go beyond the typical practices of recruiting and retaining students of color. Marriage and family therapy educators must assume positions of leadership by transforming graduate programs to reflect a deep, active, systemic commitment to both diversity and social justice. In this article, we argue that it is through this type of transformation that programs become truly ready to support students of color and to prepare all therapists to advocate for equity in a diverse, often unfair society. This article offers a model that addresses readiness, recruitment, retention, assessment, and professional development from this perspective.

Context: The evaluation of competence in the health professions is of great importance to the public and professionals alike. Recent efforts to design dependable and accurate systems of assessment for demanding clinical roles are increasingly attempting to focus on all-round competence of practitioners. Many challenges are faced in this field as a balance between robust assessment methodology and feasibility in practice is crucial to implementation and adoption. Objectives: The authors discuss some of the challenges faced by educators and clinicians involved in the development of systems of assessment for the health professions, and describe a method which aims to address these issues in the assessment of postgraduate dental training in Scotland. Discussion: Three of the major challenges facing educators and clinicians involved in the design of competency-based systems of assessment are considered: the requirement for evaluation in different areas of competence; the importance of association of assessment with the training objectives, and the types and focus of the assessment introduced. Issues around the use of formative and summative assessment, and the perception that these must always remain completely separate, are discussed in detail. Solutions: A proposal is made for the introduction of a method of assessment which has been designed keeping these challenges in mind. The rationale behind this assessment method is described.

This paper makes recommendations for the improvement of assessment in postgraduate dental education. The recommendations are based on a twelve-month study conducted in 1998/99 which evaluated the strengths and weaknesses of the existing assessment systems. Evidence was taken from examination syllabi, assessments and records. Semi-structured interviews were conducted with representatives from national bodies and with trainers and trainees in the West Midlands. Strengths in parts of the system include: commitment and professional experience; commissioned work; opportunity to share experience; a monitoring framework; procedures for maintaining standards and examples of broadbased assessments. Weaknesses include: lack of assessment of quality; existence of some forms of unregulated assessment; lack of transparency and lack of clarity between training and assessment. Development is recommended in three broad areas: a competence-based model of assessment; distinguishing assessment from the analysis of educational needs and quality assurance. The introduction of a competence-based model is the most significant and is addressed in some detail. Specific proposals for consideration by national regulatory bodies and education providers include: strengthening the management of assessment; national leadership in the development of a competence model of assessment; widening the assessment base; clearer criteria for inspection; revisions to how vocational training, HO/SHO training and general professional training are assessed and training for trainers.

While the need for evidence-based medical education is widely acknowledged, it is often assumed that the 'gold standard' used in evidence-based medicine is sufficient evidence for practising evidence-based medical education. Using the introduction of a problem-based learning (PBL) curriculum as an example, this paper argues that evidence from ethnography can provide valuable insight into medical education, although few such studies have been carried out. Ethnography attempts to capture the true nature of human social behaviour by going beyond what individuals say to what they actually do, and explores social and educational phenomena beyond mere mechanical products of our purported educational interventions. Applied to problem-based learning, ethnographic accounts would be valuable to help us understand the PBL process and improve our educational practice.

This paper describes the Cascade Communication Skills Teaching Project, which is a programme of facilitator training enabling communication skills teaching in the consultation to general practitioners to be cascaded throughout the former East Anglia Deanery. The paper also explores the project's educational and organizational effectiveness. The programme is based on an ongoing training programme for a cohort of around 30 district-based communication skills facilitators, and was set up in the autumn of 1995. These facilitators are now able to act as a resource to cascade high-quality communication skills teaching into vocational training schemes, trainer education and the continuing professional development of established general practitioners throughout each district in the region. The project has now been extended into medical student teaching, specialist teaching at junior and senior level, and multidisciplinary teaching.

An action research study using a series of staged focus groups with senior house officers (SHOs) and educational supervisors (ES) was used to identify the perceptions of the strengths and challenges in the SHO training programme and to indicate areas for improvement. The basic findings were not entirely surprising, with SHOs wanting more detailed feedback from educational supervisors and educational supervisors challenged (by time constraints and competing clinical and research responsibilities) in meeting the expectations of the SHOs. However the novel approach of using staged focus groups enhanced the educational supervisors' perception of the SHOs' view of their training and the SHOs' perception of the challenges faced by educational supervisors. Thus a culture of dialogue was created which supported change and innovation. This process was able to directly inform and influence the development of a new induction programme for SHOs and provide valuable insight into the use of the portfolio of learning and the provision of study opportunities. These findings may only be of local interest, however the method employed can be transferred to other contexts to support a grass roots approach to change. Indeed, since this study has been completed, the method has been replicated in a medical setting.

During the VT year the VDP and the trainer could choose to progressively check and complete each of the competencies listed and using the skills evaluation document make the appropriate record. Any areas of further training needs would be identified and a learning plan implemented. The whole process would be supervised by the VT advisor group who could be the resource for further training or support in conjunction with the VDP and trainer. This would be a self evaluation with external validation by the trainer and advisor group similar to the AEGD model in the USA.5, 6 This would be an assessment that was valid reliable and feasible as indentified by Freeman.8 The use of a skills evaluation procedure would be similar to a LEP which would support the validity of the process.10 A record of completion of each key skill (competency) could be made using the supplied paper work and presented periodically as a log of achievement to the VT Advisor group. Of course the whole process also relies on the fact that the trainers need to be competent themselves in using practice based assessment, and an appropriately resourced pilot programme will be needed to make this an effective tool in assessing the overall competency of new graduates in vocational training.

Objectives: The objective of this controlled intervention study was to quantify the efficacy of skin protection (SP) measures and ultraviolet B (UVB) hardening in the prevention of hand dermatitis in bakers' apprentices. Method: SP measures were compared against UVB hardening in a controlled clinical trial of 94 apprentices. The apprentices were assigned to the intervention arms class-wise. Bakers' apprentices involved in a previous follow-up study served as additional controls representing no intervention. The apprentices were interviewed and examined in a standardised was at the beginning of the training and at 4 monthly follow-ups. Transepidermal water loss (TEWL) was measured at the back of the hands. Results: Demographic profile and atopy criteria were equally distributed in the two intervention arms and the control group. Point prevalence of hand dermatitis after 6 months was highest in the controls (29.1%) followed by the UVB (19.4%) and the SP group (13.3%). UVB hardening and SP measures reduced hand dermatitis prevalence by 9.7% (95%CI: -8.5 to 28.1) and 15.7% (95%CI: -2.4 to 33.9), respectively. Application of SP measures reduced the odds ratios (ORs) for hand dermatitis 0.8-fold (95%CI: 0.17-3.70) and 0.33-fold (95%CI: 0.09-1.23) compared with the UVB group and the controls, respectively. These clinical trends were confirmed by statistically significant differences in TEWL values. TEWL values were consistently higher in the UVB group than in the SP group (P = 0.002). Conclusions: This study provided evidence, based on significant differences in TEWL levels, that general SP measures may be more effective than UV light hardening of the skin, which in turn was more effective than no intervention. This trend was supported by the frequency of development of clinical hand dermatitis, although differences did not reach statistical significance. A multi-centre trial is recommended to confirm the efficacy of SP measures in a larger randomised study. © Springer-Verlag 2002.