Alison Bullock | Cardiff University (original) (raw)
Papers by Alison Bullock
British Dental Journal
Introduction In the UK, the General Dental Council specifies nine principles of professional stan... more Introduction In the UK, the General Dental Council specifies nine principles of professional standards that dental registrants must follow. There are views that such standards are high, patients' expectations are rising, and the professionalism of dental professionals is increasingly scrutinised. This paper explores whether the high standards expected in dentistry are justified.Methods We applied thematic analysis to 772 free-text responses from dental team members and the public to a modified Delphi survey. Respondents described their views of professional and unprofessional behaviours in dentistry. Data were obtained as part of a larger review of professionalism in dentistry.Results Two lines of argument were identified: professionalism standards are high, but justifiably so; and professionalism standards are too high. Within these, four broad themes emerged: patient trust; comparison with other professions; a culture of fear; and perfection.Conclusion High professionalism sta...
Research Square (Research Square), Mar 10, 2023
Introduction: as in other health professions, professionalism is a core concept in dentistry. End... more Introduction: as in other health professions, professionalism is a core concept in dentistry. Endeavours to determine a clear de nition of professionalism in dentistry are widespread. However, there has been substantially less focus on the boundaries of professionalism, and what constitutes unprofessional or a lapse in professionalism. Aims: what leads a dentist's professionalism to be called into question? An exploration of the boundaries between professional and unprofessional and the implications for maintaining professionalism in dentistry. Methods: drawing on data from a large mixed-method study, we conducted a thematic analysis of 772 open-text responses, from dental professionals and members of the public, to an online survey. Results: two lines of argument were identi ed for the conditions under which a dentist's professionalism is called into question: circumstances that bear a direct in uence on patient care, and circumstances that lead to the loss of patient trust. We identify and review processes that build and foster patient trust and thereby maintain professionalism. Conclusion: the ndings support an approach to professionalism that mirrors a dentist's approach to clinical practice. We provide two detailed recommendations for consideration: learned and tailored interactions, and judgement and re ection. In-brief Two lines of argument are posed for the conditions under which a dentist's professionalism is questioned: circumstances that bear a direct in uence on patient care, and broader circumstances that lead to the loss of patient trust. Clinical standards are of central importance, but patient care extends beyond clinical skills and relies on patients' trust and con dence. Some view professionalism as a core attribute of an individual's character and thus the boundary between a dentist's life inside and outside the workplace is blurred. A lapse in professionalism is distinct from characteristically unprofessional behaviour. Recommendations are made for implementing learned and tailored interactions with patients and executing judgement and re ection.
International Journal of Pharmacy Practice, Dec 6, 2017
Co py ri g h t a n d m o r al ri g h t s fo r p u blic a tio n s m a d e a v ail a bl e in ORCA a... more Co py ri g h t a n d m o r al ri g h t s fo r p u blic a tio n s m a d e a v ail a bl e in ORCA a r e r e t ai n e d by t h e c o py ri g h t h ol d e r s. Community pharmacists in Englands' opinions on skill-mix and delegation Abstract Objectives Following the 2005 contractual framework amendment, the expanding role of community pharmacy team-members required a shift in entrenched views on roles and duties. This study aimed to report on community Pharmacists' opinions on skill-mix and explore how they can be addressed so that skill-mix may be optimised. Methods An invitation to complete an online questionnaire was sent via email, marked for the attention of the lead pharmacist. Following a low response, a paper-based questionnaire was sent to all community pharmacies in England (n=11,816 Questions elicited data about the respondent, the pharmacy (including staffing profile) and opinions on skill-mix. Key Findings 1154 returns were received, representing a 10% response rate. Of these, most were pharmacy chains (76%; n=877), with 5-9 staff (54%; n=600); commonly open 40-49 hours (42%; n=487), dispensing <6000 prescriptions per week (41%, n=533). From 26 statements on skill-mix, 3 factorswere identified by principal-components factor-analysis: "working well", "feeling the pressure" and "open to development". Associated with 'working well': pharmacy owners, single businesses, with a pharmacy technician, dispensing fewer prescriptions, open shorter hours. Associated with 'feeling the pressure': pharmacy chains, open longer hours, large numbers of prescriptions, relief pharmacists. Associated with 'open to development': recently qualified, second pharmacists, working longer hours, chains, dispensing lower numbers of prescriptions. Conclusions Although limited by a low response, results suggest being in a position to influence (more experienced, business owners) may be associated with more positiveopinions. Further training (including about legalities and leadership) could contribute to optimising skill-mix in community pharmacies.
Medical Education, Jun 1, 2001
Introduction This paper describes a study designed to evaluate assessment in postgraduate dental ... more Introduction This paper describes a study designed to evaluate assessment in postgraduate dental education in England, identifying strengths and weaknesses and focusing speci®cally on its relevance, consistency and cost-effectiveness. Methods A four-phase qualitative method was used: a mapping of current career paths, assessment policy, and issues (phase 1); more detailed studies of the practice of assessment for a range of courses, and the systemic/ management perspective of assessment (i.e. quality assurance) (phases 2 and 3), and analysis and reporting (phase 4). Data were analysed from documents, interviews, group consultations and observations. Results and discussion Five key issues may be distilled from the ®ndings: (i) lack of formal assessment of general professional training; (ii) trainer variation in assessment; (iii) the extent to which assessments are appropriate indicators of later success; (iv) the relationship between assessment and patient care, and (v) data to assess the costs of assessment. Conclusion Current assessment procedures might be improved if consideration is given to: assessment which supports an integrated period of general professional training; training for trainers and inspection procedures to address variation; more authentic assessments, based directly on clinical work and grading cases and posts, and better data on allocation of resources, in particular clinicians' time given to assessment.
British Dental Journal, Jul 1, 2018
British Dental Journal, Mar 10, 2023
Highlights the complexities surrounding whether the standards of professionalism in dentistry are... more Highlights the complexities surrounding whether the standards of professionalism in dentistry are justified. Highlights that high professionalism standards are expected in a profession where patient trust is paramount; however, dental professionals feel pressure to possess an unattainable infallible nature and fear increasingly high levels of litigation. Suggests that undergraduate and continuing professional development aim to foster a supportive, positive, and reflective culture of professionalism to help prevent a culture of fear contributing to defensive dentistry.
British Dental Journal, Apr 22, 2022
Highlights the importance of communication skills as a core element of professionalism education.... more Highlights the importance of communication skills as a core element of professionalism education. Suggests that education about team working could foster a more collaborative approach to maintaining professionalism within the dental practice. Recognises that lapses in professionalism can occur and should be reflected upon as part of ongoing learning.
To develop internationally harmonised standards for programmes of training in intensive care medi... more To develop internationally harmonised standards for programmes of training in intensive care medicine (ICM). Methods: Standards were developed by using consensus techniques. A nine-member nominal group of European intensive care experts developed a preliminary set of standards. These were revised and refined through a modified Delphi process involving 28 European national coordinators representing national training organisations using a combination of moderated discussion meetings, email, and a Web-based tool for determining the level of agreement with each proposed standard, and whether the standard could be achieved in the respondent's country. Results: The nominal group developed an initial set of 52 possible standards which underwent four iterations to achieve maximal consensus. All national coordinators approved a final set of 29 standards in four domains: training centres, training programmes, selection of trainees, and trainers' profiles. Only three standards were considered immediately achievable by all countries, demonstrating a willingness to aspire to quality rather than merely setting a minimum level. Nine proposed standards which did not achieve full consensus were identified as potential candidates for future review. Conclusions: This preliminary set of clearly defined and agreed standards provides a transparent framework for assuring the quality of training programmes, and a foundation for international harmonisation and quality improvement of training in ICM.
The British student doctor journal, Dec 1, 2019
CHAPTER 11 Hannah Barrett, Alison D. Bullock and Julian F. Bion Evaluating clinical performance M... more CHAPTER 11 Hannah Barrett, Alison D. Bullock and Julian F. Bion Evaluating clinical performance Making judgements about ourselves and others is a universal human phenomenon repeated daily in social intercourse, examination halls, or courts of law. ... The Shipman Enquiry. ...
British Dental Journal
Introduction In the UK, the General Dental Council specifies nine principles of professional stan... more Introduction In the UK, the General Dental Council specifies nine principles of professional standards that dental registrants must follow. There are views that such standards are high, patients' expectations are rising, and the professionalism of dental professionals is increasingly scrutinised. This paper explores whether the high standards expected in dentistry are justified.Methods We applied thematic analysis to 772 free-text responses from dental team members and the public to a modified Delphi survey. Respondents described their views of professional and unprofessional behaviours in dentistry. Data were obtained as part of a larger review of professionalism in dentistry.Results Two lines of argument were identified: professionalism standards are high, but justifiably so; and professionalism standards are too high. Within these, four broad themes emerged: patient trust; comparison with other professions; a culture of fear; and perfection.Conclusion High professionalism sta...
Research Square (Research Square), Mar 10, 2023
Introduction: as in other health professions, professionalism is a core concept in dentistry. End... more Introduction: as in other health professions, professionalism is a core concept in dentistry. Endeavours to determine a clear de nition of professionalism in dentistry are widespread. However, there has been substantially less focus on the boundaries of professionalism, and what constitutes unprofessional or a lapse in professionalism. Aims: what leads a dentist's professionalism to be called into question? An exploration of the boundaries between professional and unprofessional and the implications for maintaining professionalism in dentistry. Methods: drawing on data from a large mixed-method study, we conducted a thematic analysis of 772 open-text responses, from dental professionals and members of the public, to an online survey. Results: two lines of argument were identi ed for the conditions under which a dentist's professionalism is called into question: circumstances that bear a direct in uence on patient care, and circumstances that lead to the loss of patient trust. We identify and review processes that build and foster patient trust and thereby maintain professionalism. Conclusion: the ndings support an approach to professionalism that mirrors a dentist's approach to clinical practice. We provide two detailed recommendations for consideration: learned and tailored interactions, and judgement and re ection. In-brief Two lines of argument are posed for the conditions under which a dentist's professionalism is questioned: circumstances that bear a direct in uence on patient care, and broader circumstances that lead to the loss of patient trust. Clinical standards are of central importance, but patient care extends beyond clinical skills and relies on patients' trust and con dence. Some view professionalism as a core attribute of an individual's character and thus the boundary between a dentist's life inside and outside the workplace is blurred. A lapse in professionalism is distinct from characteristically unprofessional behaviour. Recommendations are made for implementing learned and tailored interactions with patients and executing judgement and re ection.
International Journal of Pharmacy Practice, Dec 6, 2017
Co py ri g h t a n d m o r al ri g h t s fo r p u blic a tio n s m a d e a v ail a bl e in ORCA a... more Co py ri g h t a n d m o r al ri g h t s fo r p u blic a tio n s m a d e a v ail a bl e in ORCA a r e r e t ai n e d by t h e c o py ri g h t h ol d e r s. Community pharmacists in Englands' opinions on skill-mix and delegation Abstract Objectives Following the 2005 contractual framework amendment, the expanding role of community pharmacy team-members required a shift in entrenched views on roles and duties. This study aimed to report on community Pharmacists' opinions on skill-mix and explore how they can be addressed so that skill-mix may be optimised. Methods An invitation to complete an online questionnaire was sent via email, marked for the attention of the lead pharmacist. Following a low response, a paper-based questionnaire was sent to all community pharmacies in England (n=11,816 Questions elicited data about the respondent, the pharmacy (including staffing profile) and opinions on skill-mix. Key Findings 1154 returns were received, representing a 10% response rate. Of these, most were pharmacy chains (76%; n=877), with 5-9 staff (54%; n=600); commonly open 40-49 hours (42%; n=487), dispensing <6000 prescriptions per week (41%, n=533). From 26 statements on skill-mix, 3 factorswere identified by principal-components factor-analysis: "working well", "feeling the pressure" and "open to development". Associated with 'working well': pharmacy owners, single businesses, with a pharmacy technician, dispensing fewer prescriptions, open shorter hours. Associated with 'feeling the pressure': pharmacy chains, open longer hours, large numbers of prescriptions, relief pharmacists. Associated with 'open to development': recently qualified, second pharmacists, working longer hours, chains, dispensing lower numbers of prescriptions. Conclusions Although limited by a low response, results suggest being in a position to influence (more experienced, business owners) may be associated with more positiveopinions. Further training (including about legalities and leadership) could contribute to optimising skill-mix in community pharmacies.
Medical Education, Jun 1, 2001
Introduction This paper describes a study designed to evaluate assessment in postgraduate dental ... more Introduction This paper describes a study designed to evaluate assessment in postgraduate dental education in England, identifying strengths and weaknesses and focusing speci®cally on its relevance, consistency and cost-effectiveness. Methods A four-phase qualitative method was used: a mapping of current career paths, assessment policy, and issues (phase 1); more detailed studies of the practice of assessment for a range of courses, and the systemic/ management perspective of assessment (i.e. quality assurance) (phases 2 and 3), and analysis and reporting (phase 4). Data were analysed from documents, interviews, group consultations and observations. Results and discussion Five key issues may be distilled from the ®ndings: (i) lack of formal assessment of general professional training; (ii) trainer variation in assessment; (iii) the extent to which assessments are appropriate indicators of later success; (iv) the relationship between assessment and patient care, and (v) data to assess the costs of assessment. Conclusion Current assessment procedures might be improved if consideration is given to: assessment which supports an integrated period of general professional training; training for trainers and inspection procedures to address variation; more authentic assessments, based directly on clinical work and grading cases and posts, and better data on allocation of resources, in particular clinicians' time given to assessment.
British Dental Journal, Jul 1, 2018
British Dental Journal, Mar 10, 2023
Highlights the complexities surrounding whether the standards of professionalism in dentistry are... more Highlights the complexities surrounding whether the standards of professionalism in dentistry are justified. Highlights that high professionalism standards are expected in a profession where patient trust is paramount; however, dental professionals feel pressure to possess an unattainable infallible nature and fear increasingly high levels of litigation. Suggests that undergraduate and continuing professional development aim to foster a supportive, positive, and reflective culture of professionalism to help prevent a culture of fear contributing to defensive dentistry.
British Dental Journal, Apr 22, 2022
Highlights the importance of communication skills as a core element of professionalism education.... more Highlights the importance of communication skills as a core element of professionalism education. Suggests that education about team working could foster a more collaborative approach to maintaining professionalism within the dental practice. Recognises that lapses in professionalism can occur and should be reflected upon as part of ongoing learning.
To develop internationally harmonised standards for programmes of training in intensive care medi... more To develop internationally harmonised standards for programmes of training in intensive care medicine (ICM). Methods: Standards were developed by using consensus techniques. A nine-member nominal group of European intensive care experts developed a preliminary set of standards. These were revised and refined through a modified Delphi process involving 28 European national coordinators representing national training organisations using a combination of moderated discussion meetings, email, and a Web-based tool for determining the level of agreement with each proposed standard, and whether the standard could be achieved in the respondent's country. Results: The nominal group developed an initial set of 52 possible standards which underwent four iterations to achieve maximal consensus. All national coordinators approved a final set of 29 standards in four domains: training centres, training programmes, selection of trainees, and trainers' profiles. Only three standards were considered immediately achievable by all countries, demonstrating a willingness to aspire to quality rather than merely setting a minimum level. Nine proposed standards which did not achieve full consensus were identified as potential candidates for future review. Conclusions: This preliminary set of clearly defined and agreed standards provides a transparent framework for assuring the quality of training programmes, and a foundation for international harmonisation and quality improvement of training in ICM.
The British student doctor journal, Dec 1, 2019
CHAPTER 11 Hannah Barrett, Alison D. Bullock and Julian F. Bion Evaluating clinical performance M... more CHAPTER 11 Hannah Barrett, Alison D. Bullock and Julian F. Bion Evaluating clinical performance Making judgements about ourselves and others is a universal human phenomenon repeated daily in social intercourse, examination halls, or courts of law. ... The Shipman Enquiry. ...