examination and many new examiners have been recruited and trained. All parts of the MJDF have been subject to ongoing internal and external quality.
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M J D F E X A M I N AT I O N
The rise and rise of the MJDF
Ann R Coll Surg Engl (Suppl) 2010: 92:308–309
High praise for the MJDF
MICHAEL ESCUDIER CHIEF EXAMINER FOR THE MJDF EXAMINATION
All dental graduates now enter a foundation training programme that prepares them for further career choices in terms of general dental practice (with the option of developing enhanced skills in areas of interest) and specialist training pathways. The Faculty of General Dental Practice (UK) (FGDP(UK)) and Faculty of Dental Surgery (FDS) at The Royal College of Surgeons of England offer a single assessment as a clear marker of the successful completion of this period of training: the Diploma of Membership of the Joint Dental Faculties (MJDF). This enables career choices to be held open in the important early years following graduation. The graduate may then choose to follow the FGDP(UK)’s Career Pathway for general dental practitioners or specialist training pathways offered by the FDS and other dental faculties in the UK.
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The assessment has enjoyed remarkable success since its introduction in September 2007, both in terms of the number of candidates sitting the assessment and in external peer review. During the period, candidate numbers have risen from 176 to 700 for part 1 and 166 to 374 for part 2 of the examination. While this increased demand has been easily accommodated in relation to part 1, it has led to the need for bigger venues and greater numbers of examiners for part 2. To facilitate this, unconventional venues such as Chelsea Football Club and the Surrey County Cricket Club have been used to stage the examination and many new examiners have been recruited and trained. All parts of the MJDF have been subject to ongoing internal and external quality assurance and have received excellent feedback. Part 1 has been reported as being ‘well on its way to being a worldclass examination’ and the examiners for both components of part 2 have been applauded for their quality, reliability and fairness.
Combined expertise
The MJDF is open to all graduates who hold a primary dental qualification acceptable to the boards of both dental faculties and who are registered to practise dentistry in their country of residence. The assessment was developed by a group of representatives drawn from each faculty in collaboration with educational advisors. The process was greatly enhanced by the ability to draw on the expertise of individuals based in both
primary and secondary care. It also drew on current educational best practice to maximise its reliability, validity and fairness. The structure of the assessment comprises a two-part examination and a portfolio of workplace-based evidence. Each area was developed by teams of examiners led by a representative from each of the faculties. These three elements of the examination assess different areas of knowledge, skills and competence, and so enable triangulation across the curriculum and increase the validity of the process as a whole. The portfolio provides evidence of core skills drawn from the candidate’s foundation training and working environment. Given the workplace-based nature of this element and its ongoing nature, it provides a highly valid educational tool. The clinical areas covered are: clinical record keeping, infection control, legislation and good practice guidelines, medical emergencies, radiography, risk management and communication, and team training. In addition to these areas, the candidate is required to complete an audit project and a comprehensive report on a clinical case; the key aim of the latter is for the individual to demonstrate understanding and learning as well as the ability to reflect on his or her clinical practice. The portfolio will also continue to develop and hopefully minimise duplication in addressing the needs of revalidation and evidence for the Care Quality Commission.
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THE ROYAL COLLEGE OF SURGEONS OF ENGLAND BU L L E T I N
Robust and innovative assessment tools
The part 1 examination is three hours long and is aimed at assessing knowledge and its application using a multiple-choice question format. Content and psychometric concerns mean that the negatively marked true/false format is no longer recommended for high-stakes examinations. The examination therefore consists of single-best-answer and extended-matching decision-making exercises, which allow assessment of higher cognitive skills and are mapped to the curriculum. This has proved to be a very reliable assessment tool, achieving Cronbach’s alpha scores for all MJDF diets of around 0.9, which is thought to be the ideal for high-stakes professional examinations. The part 2 examination comprises an objective structured clinical examination (OSCE) and the innovative structured clinical reasoning (SCR) exercise. The OSCE component is aimed at assessing the philosophy guiding the candidate’s practice, as well as his or her competence and application of knowledge. There are
normally at least 20 OSCE stations (including some rest stations) each of five minutes’ duration. The candidate is asked to complete a clinical task, such as history taking or suturing, or a paper-based data analysis exercise. The candidate’s performance during the task is assessed against previously agreed criteria using a predetermined rating scale. The SCR section is an assessment of the candidate’s ability to communicate with peers, reason, evaluate, form opinion and apply knowledge obtained through undergraduate and postgraduate experience to current dental practice. It is not primarily an assessment of recall or knowledge, although these elements are required to undertake SCR. Candidates are allowed one hour to consider background material to the scenarios, which is followed by five ten-minute structured discussions with two different examiners on each occasion on selected aspects of each scenario.
Effective collaboration
In keeping with current educational best practice, the foundation training
assessment is underpinned by a curriculum, namely A Curriculum for UK Dental Foundation Training. In addition, all elements of both part 1 and part 2 of the MJDF are standard-set using accepted educational best practice. A fundamental principle in this process is that the pass marks are criterion-based rather than norm-referenced. Hence they are based on decisions about the questions rather than about the group of candidates. As a result, there is no quota of candidates to pass or fail; all candidates can pass the assessment if they reach the required standard. There is no doubt that the development and implementation of the MJDF has been a great success in terms of both candidate acceptance and uptake, and peer review. That this has been achieved in a relatively short time is a testimony to the ongoing enthusiasm, commitment and support of the examiners, as well as that of the administrative teams within both faculties. It reflects a process of highly effective collaborative working between the two faculties in support of foundation training.
Deaths Council noted with regret the death of the following fellows and members of the College: ALEXANDER, Albert Geoffrey, of Milton Keynes, FDS 1961 BANKS, Charles Neville, of Randwick, Australia, FRCS 1969 BURTON BROWN, Jean Rosemary Campbell, of Westgate-on-Sea, FRCS 1948 CASSIE, Alistair Baxter, of Edinburgh, FRCS 1958 CRICK, Ronald Pitts, of Poole, FRCS 1950 DALLIWALL, Kenneth Hayat Singh, of Great Yarmouth, FRCS 1943 DOOLEY, Denis, of London SW19, FRCS 1975 DUNNING, Mervyn Walter Frank, of Shrewsbury, FRCS 1957 DYDE, John Anthony, of Leamington Spa, FRCS 1963 GILLING SMITH, Geoffrey Lawrence, of Liverpool, FRCS 1987 GRIFFITHS, Jonathan David, of Bath, FRCS 1968 HARDY, Eric Gordon, of Norwich, FRCS 1958
HAW, David William Martin, of York, FRCS 1960 IVES, Louis Arnold, of Hants, FRCS 1941 LAWRENCE, George Anthony, of Amherst, Canada, FRCS 1962 LUND, William Spencer, of Woodstock, FRCS 1959 MACAFEE, Alastair Lowry, of Donaghadee, FRCS 1967 OSUNG, Okon Akpan, of Neath, FRCS 1977 PARKHOUSE, Helen Fitzmaurice, of Haywards Heath, FRCS 1982 RAMSAY, Gordon Stuart, of Villereal, France, FRCS 1949 SHEPHERD, Rolf Carter, of Wareham, FRCS 1955 SHIRES, Peter Rodney, of Guildford, FRCS 1959 SPENCER, Pamela Mary, of Wadebridge, FRCS 1957 STOYLE, Thomas Frederick, of Leicester, FRCS 1961 TINDALL, Victor Ronald, of Altrincham, FRCS 1991 WOO, Karen Su Ying, of London W12, MRCS 2008
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