At the time of application opening, how many complete quality improvement projects (QIP) or complete audit cycles (i.e. first audit/project, action plan and re-audit/assessment to quantify impact of intervention) have you undertaken in the last 36 months (WTE)** of employment (excluding any periods of statutory leave)?

Evidence for no more than a total 3 audits /QIP should be included

Select From

• None : 0
• One complete audit cycle (i.e. first audit/project, action plan and re-audit/assessment to quantify impact of intervention/QIP) : 2
• Two separate complete audit cycles/QIPs : 4
• Three separate complete audit cycles/QIPs : 6

Evidence:

• For each QIP/audit please provide a summary (e.g. PowerPoint presentation) including:
  • First QIP/audit
  • Action plan
  • Evaluations/re-audit/assessment to quantify impact of intervention, led by yourself.
  • Dates QIP/audit undertaken
• Please evidence your involvement in each QIP/audit e.g. email acknowledgement of registration of QIP/audit with Clinical Governance team or response from QIP/audit lead.
• You must provide evidence for LTFT posts e.g timetable/job plan

Please select the statement that best describes your experience, at the time of application opening, of delivering formal teaching events of relevance to dentistry.

These should be a minimum length of 30 minutes and could be a small group (at least 2 attendees) tutorial or lecture.

This excludes clinical supervision and should only include teaching sessions delivered to adult learners.

Select From

• No teaching experience : 0
• I am occasionally engaged in teaching e.g. small group tutorials, lectures, seminars etc. on no more than 6 distinct occasions (lectures and presentations to your fellow orthodontic specialty trainees as part of your orthodontic programme do not count). : 1
• I am occasionally engaged in teaching e.g. small group tutorials, lectures, seminars etc. on at least 6 – 10 distinct occasions (lectures and presentations to your fellow orthodontic specialty trainees as part of your orthodontic programme do not count). : 2
• I am regularly engaged in teaching e.g. small group tutorials, lectures, seminars etc. on 11 or more within the last 36 months (WTE) : 4
• I have worked with local tutors to independently design and organise a teaching programme to enhance locally organised teaching and contributed regularly to teaching on 6 or more occasions over a 12-month period (lectures and presentations to your fellow orthodontic specialty trainees as part of your orthodontic programme do not count) : 6

Evidence:

• Please provide collated evaluation from attendees who were present at each of the teaching events, which should include the date, time and title of the teaching session, how long the session lasted in minutes/hours, the target audience and number of attendees
• The collated evaluation must be verified by a senior colleague and evaluations should be mapped to learning outcomes.
• If involved in designing, organising and delivery of a teaching programme, evidence should include letters/emails confirming level of involvement.
• Please do not upload copies of presentations or slides.

At time of application opening, have you achieved any academic publications as a postgraduate relevant to orthodontics within the last 60 calendar months (WTE)*. This excludes published abstracts.

Select the highest scoring option applicable.

Select From

• None : 0
• I have published a letter, book review or audit report (e.g. in BOS clinical Effectiveness Bulletin) or non-peer reviewed article (including e-publications). Publications must be relevent [sic] to Orthodontics : 1
• I have published a case report (including e-posters), relevent [sic] to Orthodontics : 3
• I have published one article (other than audit) from a study e.g RCT or Systematic review in a peer reviewed PubMed listed publication relevant to Orthodontics : 4
• I have published more than one article (other than audit) from a study e.g RCT or Systematic review in a peer reviewed PubMed listed publication relevant to Orthodontics : 5
• I have published one article (other than audit) from a study e.g. RCT or Systematic review in a peer reviewed PubMed listed publication as a first author relevant to Orthodontics : 6

Evidence:

• For each publication, please include a screenshot or pdf copy of the publication or the acceptance letter from the relevant journal
• Do not include publication of a poster or an oral presentation abstract as they will not be counted as evidence.
• Publications must be clearly relevant to Orthodontics
• It is the applicant’s responsibility to evidence that the publication is peer reviewed.
• You must provide evidence for LTFT posts e.g timetable/job plan.

Have you given a local (within working environment), regional (deanery or NHS region), national (UK wide) or international (international/continent society meeting) oral presentation within the last 60 months (WTE)** prior to the application opening date

This excludes an oral narrative to a poster presentation.

Select the highest scoring option applicable.

Select From

• None : 0
• Local : 1
• Regional : 2
• National e.g. British Orthodontic Society Conference : 4
• International conference e.g. European Orthodontic Conference, IADR : 6

Evidence:

• Please provide a copy of the relevant page of the meeting programme/(s) naming you as a presenter.
• This can include cancelled events (due to the pandemic) at which you have been invited to speak. Please provide speaker programme as evidence.
• An oral narrative to a poster presentation is excluded from this category
• You must provide evidence for LTFT posts e.g timetable/job plan

Have you given any local (within working environment) / regional (deanery or NHS region) / national (UK wide) / international (international/continent society meeting) poster presentations in the last 60 months (WTE)** prior to application opening date?

Select the highest scoring option applicable.

Select From

• None : 0
• Local : 1
• Regional : 2
• National e.g. British Orthodontic Society Conference : 3
• International conference : 4
• International Specialist Orthodontic Society conference e.g. European Orthodontic Conference, IADR : 5

Evidence:

• Please provide a copy of the relevant page or digital screenshot of the meeting programme(s) naming you as a presenter
• You must provide evidence for LTFT posts e.g timetable/job plan
• Evidence can include ePosters

What evidence can you provide for commitment to Orthodontics, in the last 36 calendar months (WTE)** prior to the application opening date.

Select the highest scoring option applicable.

Select From

• No evidence : 0
• Attendance at a national or international Orthodontic specialist society meeting/conference : 2
• Attendance at more than one national or international Orthodontic specialist society meetings/conferences : 4

Evidence:

• Proof of attendance for each meeting/conference, for example, a certificate of attendance or acknowledgement letter. Evidence of booking does not confirm attendance.
• You must provide evidence for LTFT posts e.g timetable/job plan

At the time of application opening, what management and leadership experience/formal training do you have as an undergraduate or postgraduate dentist?

Select From

• I have not had the opportunity to manage others or demonstrate leadership : 0
• Completion of a NHS focused leadership/management course e.g. Edward Jenner : 1
• A leadership role e.g. Trust/HEI Junior Dentist representative, BDA/Specialist Society, Clinical Leadership Fellow, Primary Care NHS Network role/Senior Leadership or Management role within a Dental Practice : 3
• I have completed an NHS management/leadership course and undertaken a leadership role e.g. Trust/HEI Junior Dentist representative, BDA/Specialist Society, Clinical Leadership Fellow, Primary Care NHS Network role : 6

Evidence:

• Proof of appointment to leadership role(s) and confirmation of duties carried out must be validated by senior clinician (i.e. in a non-training grade e.g. a Consultant or Specialist) or employer including duration of role and impact of your involvement.
• Evidence of course completion or certificate of completion.

What further evidence can you provide for your commitment to Orthodontics?

Select From

• I am not employed as an Orthodontic Specialist nor am I in a current ST3 Training Post
• I can evidence sustained delivery of NHS practice in Orthodontics
• I am an active participant of a local Orthodontic study circle
• I have held Research Grants in Orthodontics
• I hold a mentoring role in Orthodontics e.g. for Orthodontic Therapist, Dental Nurse
• I am a member of a research network
• I hold a Postgraduate degree qualification in Orthodontics
• I am either currently a GDC registered Orthodontic Specialist or I am currently in an NHS ST3 Orthodontic Training Post
• I have been working as a GDC registered Orthodontic Specialist for 12 months or more

Evidence:

• Written confirmation that you have participated in 2 or more Orthodontic study circle meetings within the last 12 months.
• Evidence of research grants.
• Certificate of completion of mentoring course.
• Evidence of membership of research network.
• Evidence of Postgraduate degree certificate.
• GDC specialist number or National Training number
• Evidence of employment contract clearly stating role and dates

At time of application opening, please select the statement that best describes your training to date in regard to teaching.

Select From

• I have no training in teaching methods
• I have had brief training in teaching methods lasting no more than 2 days or online modules e.g. teach the teachers course
• I have had substantial training in teaching methods lasting more than 2 full days.

Evidence:

• Please provide the following evidence:
• Certificates relating to completed training

I confirm that I will provide the evidence to support the answers to this questionnaire in the manner outlined in the written instructions relating to each question.

Select From

• No : 0
• Yes : 2

Evidence:

• Candidate has only provided specific documentation to support the specific questions asked within the Self-Assessment questionnaire and has not provided excessive documentation or their full Portfolio