Dental schools worldwide have been actively reviewing, modifying, and implementing evidence-based, patient-centered, comprehensive care curricula, encouraging integrated learning methods. 1, 3, 4, 6, 7 The comprehensive care planning method places the patient at the center of all oral and dental treatment considerations, factoring-in their medical and dental health status. 8 In medical and dental education, patient-centered, comprehensive care methodology has proven to be beneficial, as it allows students to gain clinical management and decision-making skills in a problem-based learning style. 1, 9, 10 The trainee’s patient-care experience is expanded upon by handling real-life cases that will be encountered throughout their careers. Thus, instilling in students the integral philosophy of a well-rounded approach to diagnosis, executing treatment, and holistic patient care.
This study is based on a final year cohort of students who experienced a hybrid model education system, as their fourth-year curriculum encompassed requirement-based and specialist care models. During their fifth (final) year of clinical training, the trainees were exposed to the CDC philosophy, involving integrated dental disciplines, such as periodontics, operative dentistry, prosthodontics, and endodontics. Hence, as the students experienced both approaches of clinical education, their responses most likely reflect a genuine assessment. In the present study, we observed a preponderance of a positive understanding of the concept behind the multidisciplinary approach for comprehensive oral care.
Oral rehabilitation using a multidisciplinary format has been previously advocated to enhance critical thinking and confidence in treating challenging cases. 11 Accordingly, the mandatory requirement of completing two comprehensive cases of oral rehabilitation in our dental program conceivably offers trainees the potential to expand their clinical knowledge and skills. It also facilitates the establishment of ethics and professionalism in delivering holistic patient care through an evidence-based interdisciplinary approach.
Clinical instructors play a pivotal role in accomplishing the required competencies in any dental educational curriculum. 7, 12 In the present study, the variability in the teaching approaches of the specialists seemed to have influenced the students’ perception of the CDC methodology. In concordance with our findings, a report from the University of Bergen reported that merely following a comprehensive care model does not seem to enrich student knowledge and contentment with teaching. 13 The teaching staff members’ knowledge, commitment, and calibration, concerning teaching and evaluation strategies, contribute to the success of the CDC paradigm. 12 For prevailing over this aspect of inconsistencies, routine rotations of specialists is important as it may allow maximum student exposure to varied learning experiences. Additionally, the clinical supervisors’ regular and routine calibration is warranted, with the aim that graduates can make the best out of this practice.
Executing a patient-centered practice approach in undergraduate clinical training assures the best possible holistic oral health care standards for overall patient satisfaction and well-being. 14 The concept of Comprehensive Dental Care was well understood by the majority of students and it helped them improve their skills in treatment planning and phasing, as well as increase their confidence. Hence, the responses related to the holistic care approach indicate that clinical courses focused on patient care continuity maintain productivity and do not need students to only focus on grades. 1
Furthermore, graded evaluation and oral defense of their oral rehabilitation case presentations in front of a panel of supervising specialists instill in trainee clinicians a greater sense of responsibility and motivation to devise the best treatment plan and provide standard care to their patients. The CDC model platform offers students time and opportunity to execute the most appropriate treatment plan for each specific patient to ensure optimal quality oral health care. Consequently, this builds up students’ confidence in patient management skills, which is one of the primary desirable outcomes in graduates. 15
Students’ responses indicate that routine case-related discussion, evaluation, and feedback from mentors and specialists were useful and enhanced their critical thinking and case management skills. This leads us to believe that students feel more assured and confident in the tasks they have routinely shadowed and been advised upon. Thus, enhanced self-esteem of students is an important outcome that in turn enhances their patient management skills. It is also necessary that mentors and specialists provide sufficient feedback on their assessment grades to help students understand and improve upon their deficiencies.
The present study has a limitation, in that it uses a “non-validated” questionnaire. Here, we also acknowledge that surveys can measure views of gain or no gains from students’ perspective but are inefficient for measuring real clinical acumen achieved by the students with a comprehensive care model.