Is an elective (placement) still a relevant part of the dental degree?
by Ruby Richardson, 5th Year Dentistry (BDSS), Tauranga
I believe that placement is still relevant and a vital part of the Bachelor of Dental Surgery course. I believe this for a range of reasons, the main ones being; in placement we experience different people and cases than those we would in the Dental school, we see ‘real life’ practice and to allow networking. In Dentistry, the role of placement is slightly different to other Health Care Professional programmes- such as Medicine or Pharmacy. This is because during our studies, we begin practicing on patients from third year and this continues throughout our studies. This means that placement isn’t so much for us to see how to treat patients but to broaden our clinical, community and cultural experience.
Each placement is with a clinic based in the community, mostly Māori or Pacific oral health providers. This is to allow us to experience community and culture by becoming integrated into the community. Cultural competency is a critical part of providing health care and these skills will be gained during our community elective placement. We will complete school visits and educate people about oral health. It has been proven that improved cultural competency leads to better health outcomes for patients (Clifford et al, 2015). On my placement, I will be working with Te Manu Toroa. This is an organisation focussing on providing healthcare to mainly Māori children using the Kaupapa framework. The Kaupapa framework is a philosophical model based around assertion of Māori leadership, recognising diverse needs of Māori, health education and incorporating Te Whare Tapa Whā for a holistic approach. Kaupapa healthcare providers have been found to be more effective, appropriate, accessible and affordable for Māori2. To be included in a Kaupapa healthcare provider and to be able to use this healthcare model, in conjunction with Te Whare Tapa Whā model, will be of great benefit to my future practice. Although we treat a range of different patients at the dental school, we do not have these opportunities to become a part of the community. This alone, I believe is sufficient to argue that placement is not only still relevant, but an important part of a dental degree.
The dental school only treats patients from the Otago region, meaning that we get to see a range of different procedures and patients from this demographic. However, there are some aspects of Dentistry that we lack exposure to, particularly; Paediatrics, Oral Surgery and Special Care Dentistry. As I hope to complete post-graduate study in Paediatrics in the future, placement offers a great opportunity for me to experience more of this before graduating. Five weeks of treating children will give me a lot more confidence in procedures specific to Paediatrics. This exposure to Paediatrics will also let me have a better idea of whether this really is something I would like to study in the future. Another example of this is for the students who are selected to go to placement in the Pacific Islands, where they get a lot of experience in oral surgery. Each placement offers a range of different opportunities in types of treatment, which I think are very relevant to our future practice.
Placement is also an important opportunity to see first-hand experience in a ‘real life’ dental practice. At the dental school, dentistry is run slightly differently than to general practice. Prior to being released into the workforce, I think it is important for us to understand the operation of a general practice. For many students, placement will be the only time that they see how a private practice works before actually working in one. This means that we will be able to see the entire process of running a clinic day to day. This will help the transition from university to working, which can be daunting, confusing and very stressful. Another large benefit is the independence gained from working in a private practice during placement, which will also help our transition. Furthermore, many students do placement in a region that they hope to be working in. Being a part of the community will allow us to meet potential employers and begin to network with dentists. These connections will be of lifelong value, with placement hosts becoming mentors for students as they enter the workforce.
To conclude, I believe that placement has a very important role in the Bachelor of Dental Surgery Degree. It allows us to become a part of a new community, meet new mentors and potential employers. We experience a greater range of dentistry and this helps us to become mature and independent in our practice. This experience is therefore invaluable to young dentists, before working as a new graduate next year.
 Clifford, McCalman, Bainbridge & Tsey, Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review. International Journal for Quality in Health Care, 10 March 2015. https://academic.oup.com/intqhc/article/27/2/89/1788185