To answer the question of whether or not faculty should only reinforce what is taught in the classroom or textbooks, I would say, yes and no. However in order for this to be acceptable the clinic staff have to be calibrated to accept alternate methods of techniques and instrumentation. We have to teach the universal methods; we want to teach students proper ergonomics, stroke techniques and fulcrum placements. Once they are competent on the basics, I feel that supplemental techniques should be allowed as long as they remain ergonomically correct. Lets say you are observing a student scaling the linguals of the upper left quadrant, she looks as thought she is having a hard time and keeps adjusting herself and the mirror to help with visibility. She turns to you and states “I just cant get this area.” Do you continue to let her struggle because that’s the way the book says you have to scale the area or do you recommend another option? You recommend another way. In the Preceptor Handbook it described the coaching process as “changing strategy to address changing situations.” I agree with this 100%. By demonstrating changing her position to the seven o’clock position, having the patient raise her chin and turning to the left, she now has direct vision and can obtain a solid fulcrum.
There are many other techniques that can be altered, specific posterior instruments used on the anterior, specific anterior instruments used on the posterior, polishing first to remove heavy plaque, etc.
The main thing you want to do as a clinical instructor is:
- Make sure the student has a solid understanding of the basic information taught and can demonstrate the skills competently in clinic.
- Reinforce that alternate methods can be helpful however, in some cases the universal method may be the only way to access calculus, so don’t rely on alternative methods to work 100% of the time.
- Ergonomics, Ergonomics, Ergonomics! Remind your students they must keep this in mind if they want to have a long successful career.
- Lead by example.
All great points you mentioned. The students must keep their fundamental skills learned while using alternative techniques. Many different methods of instrumentation and positioning are important to maintain because all patients are different, so students should not rely solely on alternative methods as you pointed out.
I agree with you completely. One has to make sure that the student is competent with the basic things before new techniques can be provided.
Good job with this post, Deb. It is extremely important that the students are aware of the modifications but do not soley rely on them and should realize when they will benefit a patient and when they will not. Ergonomics cannot be stressed enough, especially since it’s so easy to neglect (at least once a week I feel myself twisting my body in the weirdest way to use direct vision).
I like how you stress being a good example and also addressing that you can’t use alternatives 100% of the time but that they might be appropriate for some situations. It’s a balance that you have to establish, but as you gain experience in teaching you can better create this balance.
I love your main points to have as a clinical instructor when thinking of teaching students new techniques! A great thing to remember that you had mentioned is that these alternative techniques may not always work, and we need to remind the students of this. It is also good to remind the students that what they have learned, such as good ergonomics, should not be forgotten. Leading the students by example is also a great point you made. The students are able to learn a lot through watching the instructors so it is important to always remember this when working with the students.