LETTER

Dear Managing Editor

RD Maart

(BChD, MPhil, PhD) Faculty of Dentistry, University of the Western Cape ORCID: https://orcid.org/0000-0002-1560-040X

Correspondence

Dental schools across the world aim to prepare and train dental graduates to be competent and fit to practice independently. However, educators seem to differ in their objectives and ideals.

Globally, official documents on competencies for the new dental graduates were published - The American Dental Education Association (ADEA) approved competencies;¹ the Canadian dental programmes adopted a national consensus for competencies in 1994;² the General Assembly of the Association for Dental Education in Europe approved competencies for the European Dentist;³ and the Dental Council of New Zealand in 2012.⁴

For South Africa, the African Medical Education Directions for Specialists (AfriMEDS) core competency framework was adapted from the Canadian Medical Educational Directives for Specialists (CanMEDS) by the Health Professions Council of South Africa.⁵ The reason for the adoption and supplementary modification was to align the framework with the South African context and to be sufficiently generic to guide the training of all health professionals. Seven roles are included in AfriMEDS core competency framework (Health Care Practitioner, Communicator, Collaborator, Leader and Manager, Health Advocate, Scholar and Professional).⁵ As CanMEDS framework was initially developed for specialist training, the feasibility of "translation" of the core competencies for dental graduates requires deeper interrogation.

Reviewing the AfriMEDS roles requires innovative processes that should include stakeholders such as the regulatory body, academia, private and public sectors. It is unclear whether access to oral health care and oral health disease burden were considered when the seven roles were developed. Given that oral health is not set as a health priority in South Africa contributes to the complexity of the development and adoption of the AfriMEDS core competency framework for dental schools.

When reviewing these seven roles consideration should be given to the other local and international factors that impact the training of healthcare professionals in South Africa, including dentists. The local factors include the National Development Plan 2030;⁶ the inequity in the burden of disease;^7-9 and the call by the National Department of Higher Education and Training for the decolonisation of curriculum in higher education.¹⁰ A major international factor is the recommendation of the Commission on Education of Health Professionals for the 21st Century.¹¹

Giving due consideration to these local and international factors in the development of the competencies in undergraduate dental education in South Africa will be beneficial in raising the standard of oral health care in the country. For example, the call for decolonisation of curriculum acknowledges the inherent power relations in the production and dissemination of knowledge, and seeks to destabilise these, allowing new forms of knowledge which represent marginalised groups.^12-13Deconstructing the role of the oral health professional may bring a new perspective relative to our local context. In addition to these factors, COVID-19 and digital dentistry have impacted dental education and practice globally. For example, Ali et al¹⁴ reported that, compared to the educators, dental students considered online learning to be less interactive and preferred learning activities and all assessments to be delivered face to face. This underscores the need to adapt teaching practices to suit the learning needs of the students.

Similarly, Tukuru et al¹⁵ reported that in South Africa, dental students' training is largely centred around clinical practice, despite evidence showing the students believe that leadership skills are imperative in their education. Could this be an opportune time to reconsider the competencies required for dental graduates in South Africa in the 21st century?

REFERENCES

1. Ditmyer M, Mobley C, Davenport W. Evaluation of an integrative model for professional development and research. JDE. 2014;78:368-79. doi: 10.1002/J.0022        [ Links ]

2. Gerrow J, Murphy J, Boyd M. Review and revision of the competencies for a beginning dental practitioner in Canada. JCDA. 2007;73(2):157-60        [ Links ]

3. Cowpe J, Plasschaert A, Harzer W, Vinkka-Puhakka H, Walmsley A. Profile and competences for the graduating European dentist - update 2009. Eur J Dent Educ. 2010;14:193-202.https://doi.org/10.1111/j.1600-0579.2009.00609.x0337.2014.78.3.tb05687.x        [ Links ]

4. Dental Council of New Zealand (DCNZ). Competency standards and performance measures for dental therapists. DCNZ, Wellington, New Zealand (2012) Available at: http://www.dentalcouncil.org.nz/Documents/Policy/TherapistsCompetencyStandardsMeasures.pdf. [accessed 03/05/23]        [ Links ]

5. Van Heerden B. Effectively addressing the health needs of South Africa's population: The role of health professions education in the 21st century. S. Afr Med J. 2013;103:21-2. https://doi.org/10.7196/SAMJ.6463 National Planning Commission.         [ Links ] National Development Plan: Vision for 2030. Pretoria, South Africa (2011): The Presidency of the Republic of South Africa        [ Links ]

6. Mayosi, B.M., Flisher, A.J., Lalloo, U.G., Sitas, F., Tollman, S.M., & Bradshaw, D. (2009). The burden of non-communicable diseases in South Africa. The Lancet, 374(9693), 934-947Achoki,         [ Links ] T., Sartorius, B., Watkins, D., Glenn, S.D., Kengne, A.P., Oni, T., ... & Naghavi, M. (2022). Health trends, inequalities, and opportunities in South Africa's provinces, 1990-2019: findings from the Global Burden of Disease 2019 Study. J Epidemiol Community Health, 76(5), 471-481Brady,         [ Links ] E., Castelli, M., Walker, R., Grayling, M., Alaba, O., & Chola, L. (2022). The prevalence and social determinants of multimorbidity in South Africa. World Medical & Health PolicyZawada B. Invisible statues of colonisation: Regulatory curriculum requirements in South African higher education. Africa Education Review. 2020 May 1;17(3):142-57        [ Links ]

7. Bhutta, Z.A., Chen, L., Cohen, J., Crisp, N., Evans, T., Fineberg, H., ... & Zurayk, H. (2010). Education of health professionals for the 21st century: a global independent Commission. The Lancet, 375(9721), 1137-1138Begum N,         [ Links ] Saini R. Decolonising the curriculum. Political Stud. Rev. 2019;17:196-201. https://doi.org/10.1177/1478929918808459        [ Links ]

8. Du Plessis, P. (2021). Decolonisation of education in South Africa: Challenges to decolonise the university curriculum. South African Journal of Higher Education, 35(1), 54-69Ali,         [ Links ] K., Alhaija, E.S.A., Raja, M., Zahra, D., Brookes, Z.L., McColl, E., ... & Daher, H.O. (2023). Blended learning in undergraduate dental education: a global pilot study. Medical Education Online, 28(1), 2171700Tukuru,         [ Links ] M.O., Snyman, L., Postma, TC., & van der Berg-Cloete, S.E. (2021). Dentistry in South Africa and the need for management and leadership training. South African Dental Journal, 76(9), 532-536        [ Links ]

Correspondence:
Name: Ronel Maart Tel: +27 21 9373181
Email: rmaart@uwc.ac.za