Student Expectations

TIMEKEEPING

You MUST attend clinics strictly on time, 0900 for the morning session and 1330 for the afternoon session.

If you are more than 2 minutes late, you will be marked down as absent on CAFS.

If your patient cancels you are still expected to attend clinics.

I would suggest you aim to reach the dental school no later than 0845.

START OF SESSION

The first 30 minutes of the session, 0900-0930 (AM) and 1330-1400 (PM), is for case discussion and/or seminar.

I need to know what you would like to use the first 30 minutes of the session for?

I am very happy to lead a seminar discussion, if you wish, but I need to know what topics you would like covered in advance.

If I find you are asking similar questions, and spot a knowledge gap, then I will suggest a seminar on this topic(s).

I am happy to be guided by you how we use this time, please let me know your preferred option.

CLINICAL TREATMENT TIME

The time to see patients should be up to 2.5 hours, as shown below:

0930-1200 (2.5 hours)

1400-1630 (2.5 hours)

END OF SESSION TIMEKEEPING

All clinical work needs to be completed by 1200 in the morning session and 1630 in the afternoon session AT THE LATEST.

Aim to finish 15 minutes before this cut off time to give yourself some wriggle room.

Over running or marked poor timekeeping will be marked down as U for professionalism on CAFS.

You need to stick to these timings so I have time at the end of the session to:

• Register attendance on SEAtS

• Co-sign notes on HIVE

• Review and sign lab forms

• Complete taskings on CAFS

ABSENCES

If you cannot attend a session, for whatever reason, please let me and the school know ASAP via email.

MILESTONES

I need to know at the start of the session if you want me to observe a milestone. It is no good asking me at the end of the session.

PREPARATION

This is a big one. If you come to clinics underprepared for the clinical activity you are about to undertake, this can lead to a lot of questions and time wasting which would not happen if you were well prepared for sessions. If it helps, make up an aide memoire listing all the steps you need to do in that appointment.

There are a lot of basic questions which have been asked in the past, and whilst I do not expect you to have all the answers, I do expect you to have a good understanding of the basics. Basic questions being asked have included:

• How much tooth should I remove for this crown prep?

• How do I cement this crown?

• Can you design this denture for me?

• What local anaesthetic should I use

As the saying goes... fail to prepare, prepare to fail

I'm not saying you can't ask for help, of course you can, but it is important you help yourself to maximise your clinical time by preparing in advance.

JUST IN TIME LEARNING

This point ties into the one above. If you know you have a procedure coming up for the following week, which you do not understand, read up on it in advance, just before you need it, so it is fresh in your mind and you don't forget. Specific, targeted and timely knowledge acquisition can be really beneficial.

You have so many portals of information available to you, so there is no excuse for not being prepared. Read through your notes, rewatch lectures, journals, books, YouTube education channels…etc

LOCAL ANAESTHETIC

Some of you may not know how to aspirate correctly using the ultra safety plus system.

There are a couple of short YouTube videos on how to use the system on my website here:

http://www.tooth.org.uk/education/local-anaesthetic

Please watch the videos, even if you think you know what you are doing.

RADIOGRAPHS

The radiology department will reject any radiograph request without an adequate justification. If you are unsure what you need to include in your requests, please approach the radiology department for guidance.

Please consider the radiograph waiting time too and plan your session accordingly.

UNIT CLEANLINESS & CROSS INFECTION CONTROL

Unit cleanliness and organisation is very important. Please ensure your bays are kept neat and tidy, with only the kit and equipment you need on the work surfaces. Designated clean and dirty zones are also important.

UNIFORM

MFT uniform policy is being rigidly enforced, so do not fall foul of policy.

RECORD KEEPING

Clinical notes need to be up to standard. Templates can be a great way to ensure you don’t miss anything out, just edit as required. Make up your own templates if necessary.

All notes MUST have a list of diagnoses (including differential if applicable), discussion of treatment options and treatment plan too. This is particuarly imperative after a NPA or if a patient is in pain.

It is really important you also record any discussions you have had with patients, along with your advice and patient feedback.

There are some record keeping templates on my website:

http://www.tooth.org.uk/education/record-keeping

If there is ever an incident on clinic which needs to be reported, the incident number needs to be included in the patient notes on Hive.

LAB PRESCRIPTIONS

You need to read up BEFORHAND and draft what is going to be included on the lab prescription.

The prescription needs to be accurate and comprehensive.

If you have a denture case, ensure the back page of the lab prescription is filled out with an accurately labelled diagram.

Refer to your clinical and technical handbook if necessary.

Make the lab technicians job easier by ensuring there is no ambiguity in what you want, otherwise avoidable mistakes may occur.

PATIENT ALLOCATION

Patients are allocated on Hive. Do not hoard patients. Ideally no more than 5 or 6 patients per student. If you need to pass on a patient, then do this properly and ensure it is done on Hive.

PATIENT EXPECTIATIONS

Before embarking on a treatment plan, discuss the likely number of appointments needed and timescale with all patients. They need to understand how long treatment will take. If you do not do this, patients may become frustrated with the length of treatment. Let’s make sure they are reminded at every appointment about any outstanding treatment and likely timescales so they are never in any doubt.

Reinforce OH with patients as required. If patients attend for Tx with sub optimal OH, you may not be able to carry out a procedure. Even if your patient is under the care of a BSc student, you cannot defer all responsibilities to them. You must ensure your patients understand what is required of them in terms of OH. Use plaque and bleeding scores to monitor OH and give them goals for improvement. Discuss treatment phasing if necessary and explain you cannot move on to more complex treatment until stabilisation has been achieved.

PATIENT REMINDERS

Your clinical time is precious. Please make sure you remind patients (multiple times if needed) about appointments and the importance of attending. Explain that multiple SNCs and FTAs will result in removal from the treatment list. I understand there are always unforeseen circumstances, but let’s try to do all we can about minimising other patient absences. If you have a patient who you think is a poor attender, consider only booking them in for half of the session and maybe having a standby patient if possible.

NUMBER OF PATIENTS PER SESSION

I am happy for you to have 2 patients per session, but please confirm you have blocked out sufficient time to see both patients. If you are unsure how much time you may need, feel free to discuss with me beforehand (in person or via email) if you wish. If you are running late and keep a patient waiting past their appointment start time, you will be marked down for professionalism.

AMBULANCE PATIENTS

Ambulance patients need to booked for the morning session ONLY. This is because they may have to wait up to 5 hours for an ambulance to take them home. Do NOT book ambulance patients in the afternoon session.

PATIENT ABSENCE

Policy states that if a patient does not attend, the student MUST:

- attend the session at the normal times

- stay in clinic for at least an hour in case there is an emergency patient/ students absence/ help with triage clinic

- go to oral surgery/ oral medicine and ask if they need you

- do some self-directed learning using your bay computer

- mark in the patient notes and in CAFS that the patient DNA

- if after one hour the student is not needed in clinic they can leave and return at 11.00am / 15:30 to check in again.

CLINICAL TARGETS

The end of the year will come around fast. Make sure you are well organised from the start of the year and on top of getting all your milestones completed in time.

CAFS - RECORDING CLINICAL ACTIVITY

Needs to be submitted on the same day.

If you do not submit  your CAFS submission on the same day as treatment, it will be deleted.

If you do not submit any clinical activity on CAFS, a red professionalism card will be issued.

WRITTEN MILESTONES

Written milestones need to be comprehensive, with good reflection and well referenced. See here for further guidance:

http://www.tooth.org.uk/education/milestone-write-up

MOTIVIATION AND ATTITUDE

Your attitude should not be "What do I need to know to pass the exam?".

Your attitude should be "What do I need to know to be a safe practitioner? ".

GDC SAFE PRACTITIONER

These are excerpts about what the what the GDC considers to be a safe practitioner:

“Newly qualified practitioners must be safe clinicians, capable of independent and reflective practice within their defined scope and competency, from the point of registration.”

“Graduates must be able to apply sound clinical reasoning, act professionally, work collaboratively with relevant teams, communicate effectively and prioritise patient safety and dignity.”

“A Day 1 practitioner is a safe beginner – not an expert – but able to take responsibility for patient care with appropriate support structures in place”

BEHAVIOUR ON CLINIC

Please be aware of the following on clinic:

- No chatting and gossiping

- Appropriate phone use - no social media, no selfies

PROFESSIONALISM CARDS

I don't like giving out red or yellow professionalism cards, so please don't give me a reason to have to do so.

However, I will be happy to issue green cards for outstanding professional behaviour.

WHAT CAN I DO BETTER?

I want to help you as best I can and nobody is perfect. Please let me know where I need to improve so I may support you better.