Item 5 Enc B_iii_ Final UCLAN exam report

3 – 4 DECEMBER 2009
The Royal College examination and in-course assessment at the University of Central
Lancashire (UCLan) ensure that students are tested to a high degree in their clinical
skills. We found the clinical log books, in-course assessments and UCLan final
examination to be thorough, well completed by students and effectively run by the
University. We were particularly impressed by the high numbers of patients and wide
range of treatments undertaken by the students during their work placements. The
enthusiasm and commitment of the course leader and academic director create a
positive and supportive learning environment for students.
Whilst we were satisfied that clinical competence is reached before entering into the
Royal College examination, we felt that more emphasis could be placed upon academic
attainment. UCLan should also ensure that candidates’ anonymity is preserved in the
written examination.
Purpose and GDC Process
1. As part of its duty to protect patients and promote high standards, the General Dental
Council (GDC) monitors the education and assessment of dental students and dental
care professionals (DCPs). The aim is to ensure that institutions provide high-quality
learning opportunities and experiences and that students who obtain a dental
qualification are safe to practise.
2. The purpose of the inspection was to assess the Royal College of Surgeons of
Edinburgh (RCS Ed) Diploma in Orthodontic Therapy examination and the in-course
assessment at UCLan. The Diploma in Orthodontic Therapy programme at UCLan
was inspected on 22 September 2009 and a separate report covers the findings of
this inspection.
3. The GDC Education Committee will consider both inspection reports and the related
observations and decide whether the RCS Ed Diploma in Orthodontic Therapy
obtained at UCLan is ‘sufficient’ for the purposes of GDC registration as an
Orthodontic Therapist.
4. The reports and the observations will subsequently be published on the GDC
In – course assessment
5. The RCS (Ed) examination regulations for the Diploma in Orthodontic Therapy
stipulate that entry to the examination is dependant upon the following :
candidates should engage in a course of study of 120 educational credits in a
School for Dental Care Professionals or equivalent
candidates must undertake 80% of the course prior to entering the
candidates should produce a practical experience certificate confirming that
they have spent nine months full–time practical experience in an exclusive
orthodontic practice.
there should be a continuous assessment record in the form a clinical log
book, including a series of competency based assessments and a record of
theoretical assessments completed during the course.
candidates should pass an intensive course final examination at which an
external examiner is present. The examination should test the understanding
of orthodontic therapy and clinical skills and should include a practical
candidates should be registered with the GDC as a dental care professional
6. During our inspection we reviewed the students’ clinical log books, the theoretical
assessments and the final internal examination.
7. The completed clinical log books revealed that each of the students saw a very high
number of patients (15 / 16 per day) and they undertook a wide range of treatments
during their clinical work placements. We felt this provided the students with
excellent training and preparation for their work as an orthodontic therapist.
8. The log books clearly evidenced the work undertaken by the students. Students are
required to treat each competency a set number of times under direct supervision of
a mentor before being assessed and it was easy to identify when and how frequently
the students undertook each of the competencies. The ‘Summary of Progress’ form
clearly revealed how much clinical competence the student had achieved at a given
point in time. There was a well defined grading structure and there appeared to be
consistency in the grading across the log books.
9. The students had to undertake three summative assessments during the first month
of their course; a theoretical assessment on anatomy, a practical and an OSCE
examination. They undertook a further summative assessment, a research project,
about half-way through their course. We understand though that UCLan wish to alter
the number of summative assessment for future cohorts.
10. We considered the summative assessments undertaken by the initial cohort of
students were of a good standard. However, we felt that there ought to have been
more regular in-course academic assessment required as part of the Royal College
sign-up requirements. There is considerable focus on understanding and measuring
students’ clinical progress through the programme but we felt there should be more
attention paid to measuring their academic progress. This would ensure students are
of the required academic level to enter for the final in-course and Royal College
11. The final internal examination consists of a two 1.5 hour papers written papers, an
essay and a short answer question (SAQ) paper, a case study and a viva. Each part
has to be passed in order to pass the overall examination. Therefore, structurally, it
largely mirrors the Royal College examination, which is good preparation for the
students. The examination was carried out by UCLAN tutors and moderated by an
UCLAN appointed external examiner
12. We were able to view the scripts for the written papers and the marks awarded. In
respect of the essay paper, students were given a shortlist of possible topic areas in
advance of the examination. The SAQ papers were broad ranging. We felt it was
appropriate that clinical safety was thoroughly covered in this assessment. We
noticed candidate names instead of candidate numbers were written on the SAQ
answer papers, which needs to be rectified for future cohorts.
13. Successful completion of the internal course-assessment leads to the award of the
Certificate in Higher Education in Orthodontic Therapy from UCLan. GDC has not
been asked to consider this qualification for registration purposes.
Final RCS examination
14. The RCS Ed examination comprises two 2 hour written papers consisting of short
answer questions, a case presentation and a viva. Each part must be passed in
order to pass the examination overall. During our inspection, we observed the case
presentation and viva.
15. The 15 minute structured viva’s and 30 minute case presentations were conducted in
a fair and professional manner. We felt the viva’s represented a reliable and valid
assessment vehicle as real scenarios were used via a laptop. These questions
tested, in the main, students’ safety. Students were ‘held’ in a room after they had
undertaken their viva’s to prevent them from disclosing information about the
examination to other students. During the case presentations, students were
questioned on their understanding of their treatment of two patients.
16. Students are awarded a grade ranging from 1 to 4, for both the case presentation
and the viva components of the examination marks. The grade in each case was
based on a summation of the actual marks received in the examination. We did not
review the written papers. We understand that the written papers are individually
marked by Royal College examiners and their marks are averaged to obtain the final
mark for the written component. We were concerned that marks were averaged and
that there was no attempt made to reconcile the differences in marks awarded by
each individual examiner. The marks for each section are then added up to establish
whether the candidate has an overall pass or fail. The pass mark is a 3 in each
component and a 9 overall. Candidates who fail are allowed to sit the examination at
future diets within 12 months of the first final examination date only.
17. We questioned the marking scheme employed by the RCS in that it appears to place
more emphasis on how closely the examiners agree in their individual marks than on
the validity of the exam process. However, in spite of this we felt comfortable that
the students who qualified with the RCS Diploma in Orthodontic Therapy from
UCLan were safe to register with the GDC and to practice as orthodontic therapists.
Requirements of UCLan
18. To ensure there is regular in-course academic assessment (ref – paragraph 9)
19. To ensure candidate numbers are used on all examination papers (ref – paragraph
Requirements of RCS (Edinburgh)
20. To consider including regular academic in-course assessments as a sign-up
requirement for the RCS examination (ref – paragraph 9)