The evaluation of a continuing professional development package for primary care dentists designed to reduce stress, build resilience and improve clinical decision-making

Abstract

Introduction: Stress and burnout are widely accepted as a problem for primary care dental practitioners. Previous programmes to address this issue have met with some success. Burnout is associated with poor coping skills and emotion regulation, and increased rates of clinical errors. Anxiety is associated with poor decision-making and is thought to be associated with poor clinical decision-making. Attempts to improve decision-making use increasing meta-awareness and review of thinking processes. Bibliotherapy is an effective method of delivering cognitive behavioural therapy as self-help or guided self-help (with some therapist input) formats. Objective: To evaluate the efficacy of a specially designed CPD package which was designed to improve coping skills, build resilience and reduce the impact of anxiety on dentists' clinical decision-making. Design: A multi-centred quasi-experiment Setting: Lincolnshire and Nottinghamshire (England) 2014 Materials and methods: Thirty-five volunteer primary care dentists used two versions (selfhelp [SH] and guided self-help [GSH], which included a 3 hour workshop) of a specially written cognitive-behavioural-therapy bibliotherapy programme designed to improve wellbeing and decision-making. Main Outcome Measures:The main outcome measures were dentists' burnout, depression, anxiety, stress and decision-making style. Data were also collected on use and evaluation of the programme. Results: At 6 weeks there was a clinically and statistically significant reduction in depression, anxiety and stress levels, a statistically significant reduction in burnout (emotional exhaustion) and hypervigilant decision-making and an increase in personal achievement (burnout). The improvements in depression, stress, emotional exhaustion and hypervigilant decision-making were maintained at 6 months. Dentists were overwhelmingly positive in their evaluation of the project and used most of its contents. Conclusion: With the caveat of small numbers and the lack of a no-treatment control, this project demonstrated that a self-help package can be highly acceptable to dentists and, in the short-to-medium term, improve dentists' well-being and decision-making with implications for patient safety.

Psychosocial student functioning in comprehensive dental clinic education: A qualitative study

“…It is important that dental school faculties recognise the challenge of values education in the dental school environment, as value choices in schooling often remain with dentists their entire careers . Specifically, when dentists recognise the need to value stress management, there are ways to help them learn psychological resilience and positive coping skills . Leaders of dental educational institutions have the responsibility to prioritise improved communication skills and stress management for dental students.…”

“…41 Specifically, when dentists recognise the need to value stress management, there are ways to help them learn psychological resilience and positive coping skills. 42,43 Leaders of dental educational institutions have the responsibility to prioritise improved communication skills and stress management for dental students. This, in turn, affects financial and emotional priorities for the whole profession.…”

Either you Break or Brighten up: Exploring Dental Professionals’ Experiences of Dealing with Emotional Distress during Dental Practice. A Qualitative Description

“…Similarly, results of a postal survey amongst 500 dentists in UK by highlighted high levels of burn out and low work performance (Denton et al, 2008). Chapman et al (2017) evaluated a CPD package for dentists, which included a workshop for 3 hours to enhance coping skills, build resilience and improve decision making skills. They found reduced level of stress with enhanced wellbeing of dentists at 6 th week.…”

Published research on stress

“…We would like to point out that initial research into this area has already been conducted [4][5][6][7] and published in this journal. It resulted in an evidence-based self-help programme 8 which was both statistically and clinically effective in both the short-and longer-term. Participants in the research and programmes run to date have included a range of practitioners, from foundation dentists to established dentists in general practice.…”