tag:blogger.com,1999:blog-51432889013702600022024-03-19T06:37:33.948+00:00Primary Dental CareA blog that tries to assist clinical decision-making by using evidence and other resources - by Dominic HurstDominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.comBlogger93125tag:blogger.com,1999:blog-5143288901370260002.post-57530407497999597192017-01-08T16:24:00.000+00:002017-01-08T16:24:14.575+00:00
Narrative and knowledge sharing
As a consequence of my research at the University of Oxford, I have become intrigued by the role that stories play in spreading knowledge among dentists.
We spend a lot of time discussing cases, reformulating ideas of how best to diagnose and manage our patients' problems and recounting past events to ourselves and others. Storytelling is endemic and Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-62803748337816342582015-01-07T22:00:00.000+00:002015-01-07T22:00:47.495+00:00Peer reviewers: Does the study have the potential to advance our understanding of this area of practise?
I think practising dentistry in an evidence-based way is tough. There's a lot we have to do about which there's barely any research evidence. Then when we do find research it's often so poor we wish we hadn't spent a few more precious minutes of our lives searching for and then reading it.
Don't you wish editors were less inclined to publish studies that add nothing to our understanding of a Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-65368389947080920162014-12-30T15:58:00.000+00:002014-12-30T15:58:27.359+00:00Communicating oral cancer risk due to alcohol
A little while ago I tweeted about a systematic review on alcohol and oral cancer risk that the dental elf had flagged up.
When you ask patients about alcohol intake do you communicate the risk of oral cancer? http://t.co/NUS8frY9GC @thedentalelf
— Dominic Hurst (@Dominic_Hurst) December 4, 2014
But how can be communicate risk in a balanced, non-alarmist, but hopfully behaviour changing way?
Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0London, UK51.5073509 -0.1277582999999822351.1912379 -0.77320529999998222 51.8234639 0.51768870000001777tag:blogger.com,1999:blog-5143288901370260002.post-54412793368473509572014-12-23T12:03:00.001+00:002014-12-23T12:03:48.885+00:00Health demotion interventions
Oral health promotion
I am in the process of writing a piece about how to engage general dental practitioners in oral health promotion drawing on theories and empirical research around how to change professionals' practice. The Ottawa declaration defined health promotion as "the process of enabling people to increase control over, and to improve, their health". The scope of those Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-68773950756376981302014-12-04T21:35:00.000+00:002014-12-04T21:35:38.130+00:00Decision aids and option grids in undergraduate teaching
Communicating evidence to patients
There are always obstacles to using best research evidence with our patients to help them make decisions that are right for them. One of these is the actual conversation and decision-making process we engage in with patients. Assuming we have identified research to help quantify the relative benefits and harms of different treatments how do we communicate Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-58006085172542029662014-03-18T08:58:00.001+00:002014-03-18T08:58:24.716+00:00UK EBD Teachers' Group inaugral meeting
UK EBD Teachers' Group
Seven representatives of UK dental schools who are responsible for the delivery of Evidence-Based Dentistry learning met online for the first time yesterday.
Nicola Innes from Dundee and myself initiated the formation of the group out of a recognition that there was probably some good practice, learning materials and other resources that could be shared between us Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-71191001733856990952014-02-23T22:07:00.000+00:002014-02-23T22:07:32.065+00:00Educational prescription Prezi
Time moves on and finally our new cohort of undergraduate dental students is preparing for clinical practice. I have thoroughly pummeled them with evidence-based thinking over the past two years and hope that we can carry it on to the clinic, where it belongs.
A while ago I blogged about the educational prescription. Now we get to see how it works with students. To prepare them in my usual "Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-25323521580367396482014-01-16T10:09:00.002+00:002014-01-16T10:09:37.903+00:00Enough of "Real EBM" do we need "Real EBD"?
On Tuesday this week I was fortunate to be able to be in Oxford to listen to a number of "big" thinkers in the Evidence-Based Medicine (EBM) world discuss what "real EBM" is or should be compared to "rubbish EBM".
My sense was that there was a feeling that the EBM phrase had become muddied over time, perhaps as it has become used for political and persuasive methods rather than as a skill or Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-63009777796753316932013-12-19T10:03:00.001+00:002013-12-19T14:19:16.491+00:00Flip teaching critical appraisal using Prezi
Flipping critical appraisal for dental undergraduates
Flip teaching
I am designing and implementing a new Evidence-Based Dentistry (EBD) curriculum for dental undergraduates at Barts and The London School of Medicine and Dentistry, QMUL, and am using blended learning or "flip teaching".
The idea is to give students learning material and tasks to do in their own time and to come to seminars Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-79754192469523240312013-11-27T12:42:00.000+00:002013-12-01T09:01:30.811+00:00Knowledge exchange in dental practice
Knowledge exchange in dental practice
My DPhil research out here at Oxford has taken me into (for me) some fascinating literature about the nature of knowledge and research. Having begun with what I now realise was a naive question - how to help clinicians practice more evidence-based dentistry - I have moved towards trying to understand better how research knowledge does or could fit in Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-8048363140609096222013-09-16T16:39:00.000+01:002013-09-16T16:45:53.640+01:00Presenting Evidence on Clinical Topics
How to do a presentation on EBD and Endodontics
A former student contacted me yesterday to ask if I could help provide some guidance on how to go about doing a presentation on EBD and endodontics. Where should he start, he asked and how should he go about it?
So I thought I'd blog a response in case anyone else has to do an EBD presentation on some aspect of dental care.
A little bit like Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com1tag:blogger.com,1999:blog-5143288901370260002.post-37759080242524233002013-08-21T21:14:00.002+01:002013-08-23T10:27:34.045+01:00Why quantitative studies cannot deliver evidence-based practice alone
Qualitative methodology is pants and has no role in evidence-based practice
It's not uncommon to share a room with a colleague who is repelled by the idea that qualitative research could contribute to improving patient care. There are many more (and I was one) who just don't get where qualitative research fits in and it seems to me that the evidence-based practice (EBP) movement, in someDominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-39913230388817475352013-08-19T11:59:00.001+01:002013-08-19T21:08:30.568+01:00Qualitative enhancement of Quantitative Systematic Reviews
Some questions need qualitative methods to answer them - even in EBM
In my metamorphosis from EBM quantitative ideologue to more nuanced appreciator of mixed research methods I am learning to re-interpret the value of much of the evidence-based practice I have spent the last several years learning and trying to practice. As many have identified before me (e.g. Black 1994, Popay & WilliamsDominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-8751960748853529272013-06-27T10:37:00.000+01:002013-06-27T11:17:15.709+01:00Time to stop wasting data: The Clinical Practice Research Datalink
Let's stop wasting data
I was speaking at an event last night for general dental practitioners who are involved with, or interested in joining, studies in dental practice. One of my fellow speakers was a very engaging speaker called John Parkinson, who is director of the The Clinical Practice Research Datalink (CPRD) about which I will speak a little later.
Diagnostic codes
A little Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-22723516506304634872013-06-09T21:40:00.001+01:002013-06-09T21:40:48.999+01:00Respecting tacit knowledge in knowledge transformation
I used the term knowledge transformation in the title of this blog instead of the common terms knowledge translation or knowledge implementation because, as Morgan Meyer and others have argued, knowledge is rarely used in its original sense.
In a previous blog I discussed Gabbay and Le May's work in general medical practices that led them to understand that doctors create their Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-1063730013944311402013-04-22T12:16:00.000+01:002013-04-22T12:16:58.638+01:00Mindlines and Evidence-Based Practice
When I began my DPhil at Oxford I proposed a research idea that would look at the system within which dentists work and develop an intervention to help increase the use of evidence-based practice. I was thinking of the now ubiquitous 5 stages of ask, search, appraise, apply, evaluate.
However useful these skills, though, I realised pretty early on in my reading that helping dentists to do Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com1tag:blogger.com,1999:blog-5143288901370260002.post-13758738260199625732013-04-07T17:17:00.002+01:002013-04-07T17:18:20.108+01:00MOCOLS: Massive Online Communities of Learners
Many of you will be aware of the term MOOCS - Massive Open Online Courses - and depending on who you listen to they're either going to sweep away university education as we know it or pass on by like many other fads.
But what I have become aware of is how many dentists and students I communicate with online either via this and other blogs, through the videos I've done on YouTube, my Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-76368249339499994092013-03-31T22:50:00.001+01:002013-03-31T22:50:16.225+01:00A PICO Venn Diagram
PICO as a Venn Diagram
I created this Venn diagram to demonstrate how the different components of PICO overlap. As we look for studies we aim to find those that have as many of the components we are interested in as a possible.
In this Prezi you can control where you go by clicking on different overlapping parts.
Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-42413664502559171402013-02-16T13:37:00.000+00:002013-02-17T16:09:20.374+00:00Diagnostic codes for GDPs in the UK
Diagnostic codes
Diagnostic codes are a means to record the findings and diagnoses for patients in a standardised manner and have been used in electronic health records for some time in the medical world. But dentistry has lagged behind with the only items being recorded those that are related to treatment.
Why record diagnostic codes?
If we want to assess the suitability of patient Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com1tag:blogger.com,1999:blog-5143288901370260002.post-41375511609275157922013-01-13T21:13:00.002+00:002013-01-13T21:13:39.807+00:00Number Needed to Educate (NNE)
As someone who teaches both general clinical dentistry and, increasingly, evidence-based dentistry to postgraduates and undergraduates, I have been interested in how we actually measure the effectiveness of our teaching. But I have recently become very interested in how we as clinicians are encouraged to move toward more evidence-based practice and how as postgraduate educators we facilitate Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-72267249554949542102013-01-08T11:28:00.000+00:002013-01-08T11:29:20.929+00:00Survey on Practice Management Systems and your willingness to let me into it!
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Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-46388853860263122002012-12-29T15:20:00.003+00:002012-12-29T15:20:51.656+00:00General Dental Council, CPD and what the point of it all is
The General Dental Council is, until the end of January 2013, seeking comments from the public and dental professions on its new ideas for CPD.
As I've learnt more about the way we do - and don't (largely) - put new knowledge into practice I have become more sceptical that sitting in a lecture theatre for 15 / 20 / 50 hours a year is going to change my practice much. Indeed, there is a Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-39180038386267832812012-12-23T14:44:00.001+00:002012-12-24T14:11:31.106+00:00What evidence is supporting what you're being told to do?
Communication, evidence and ignorance
We had a patient come in with irreversible pulpitis in a lower premolar a few days ago. The student treating the patient was good clinically and she opened the tooth, did all the necessary instrumentation and a was ready to obturate. But she hesitated. She had been taught that you don't obturate when a tooth (or its periodontal ligament) is symptomatic. WeDominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0Mitte, Mitte52.519444 13.406667tag:blogger.com,1999:blog-5143288901370260002.post-82302393653468273112012-12-21T15:13:00.000+00:002012-12-21T15:13:09.798+00:00December issue of EBD journal out
The December issue of the Evidence-Based Dentistry Journal is out.
If you are an undergraduate at QMUL you have full access through your institutional login.
If you're a BDA member you get access through your automatic subscription to the BDJ.
If you're working for the NHS in England and are not a member of the BDA then you should get access through your local NHS Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0tag:blogger.com,1999:blog-5143288901370260002.post-29707074996710303252012-12-19T10:13:00.000+00:002012-12-19T10:15:53.730+00:00Prezi
This blog has little to do with evidence-based dentistry but is simply to draw attention to Prezi. I have used this presentation software in preference to PowerPoint for a couple of years and personally find it much more fun to use. I was chatting about this with a couple of students on clinic this week and thought it may be helpful for others to know about it too.
Students and teachers get to Dominic Hursthttp://www.blogger.com/profile/18031466284363931623noreply@blogger.com0