Focusing on the need of an orthodontic patient is imperative. Sometimes the patients are suitable for students and students are also eager to treat them. However, how students will learn from treating that patient has to be planned and thought about. Balancing these different needs is difficult. Over-treatment or maybe a shift in the treatment plan in order to meet demands of the curriculum and/or the student becomes a serious point to ponder. However in the patient’s interest it must be avoided; so should the use of students as mere service providers. Patient-orientated teaching may be appropriate but care has to be taken to see that the student has the opportunity to demonstrate a wide range of competences. Orthodontic service provision, for example by residents or employed dentists may enable a teaching unit to provide necessary care for patients while transferring suitable patients to a student for procedures that have value in the education of the dental student.
Costs to the patient may also limit treatment possibilities. The type of patient seeking care may not have the level of expectations from their treatment that the dental school wishes to impart to its students. Assessment methods will need to be adjusted if a dental school moves from teaching-led care to patient-led care. Maintaining progress and high standards is difficult when the expectations of the patient and the dental school are not aligned. Recent advances in clinical simulation may help resolve this problem by providing close-to-realistic experience of clinical procedures for which suitable patient material is not available to the dental student. Such simulation also has an important place in continuing education of the qualified dentist.
Student experience must be recorded in order to judge the competences attained. Sharing orthodontic patients may be necessary in order to get experience to different clinical scenarios but this has the disadvantage of removing the benefit for the student of having completed whole patient care and meeting the requirements of residency exit examinations.
Professor Ulfat Bashir