Ethical approach of the patient in dental university clinics

Objective: Dental students have a clinical activity under the supervision of teachers. This can disturb the usual relationship between the patient and the practitioner leading to ethical problems. The objective was to construct a scale to position the ethical approach of the patient by the student-teacher team between two extreme situations: the patient who deserves optimal care vs the patient is ignored in favour of teaching opportunities.

Methods: This qualitative research was based on 14 audio recordings carried out during preoperative consultations before dental extraction in the clinic of the Dental Faculty of Clermont-Ferrand, France. Each consultation was recorded using a cassette recorder and then transcribed. Content analyses were made using the verbatims. The analysis consisted of two major phases: an inductive phase (n=6) with the identification of the study variables and the construction of the scale and a deductive phase (n=8) in which the scale was tested.

Results: Eight topics were identified as variables and included in the scale: communication with the patient, knowledge of the patient's record, discussion of the treatment plan, search for additional information, confidence in the student's competence, absence of traumatising words, quality of information and consent. For each variable, a score=1 was given when the topic was identified as satisfactory. The scores obtained for each variable were summed. The scale was graded from 0= “the patient is ignored” to a maximum of 8 = “the patient deserves optimal care”. During the deductive phase, the scale was used: 3 patients deserved optimal care, 2 patients were ignored in favour of teaching opportunities and 3 patients were in a medium situation.

Conclusions: The scale allows assessing the global approach of the patient in dental learning situation. The topics need to be validated by an expert group before testing the scale in different clinical situations.