how to succeed in clinic

[cluelessdr]

im a d2 in pre clinic and before i know it ill be down in the clinic seeing patients. I know every school is different, but what is one tip you can give to a d2 in order to be the best he can. anything i should do in preclinic in the time i have left? any time management tips? how to get as much experience i can before i graduate to feel prepared? thanks

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[MIIMtodent]

Prepare for each patient the night before!! Here is how to do that:

1. Talk to an upperclassman and see what instruments/equipment/materials exactly you will need for each type of appointment. Make a list on your phone for each type of appointment so when you are setting up your room you can go down the checklist and make sure you are prepared. Sometimes it even differs depending on what faculty you are working with that day, so just asking someone who has worked with them before, "What type of material does Dr. XYZ like to use for ABC?" will help you be ready and have that material in your op.

2. Go through the patients medical history/chart/dental history/medications etc and know what everything means. At least at my school, when you present a patient for a start check or for whatever especially in the beginning they want to make sure you know what each medication means and what its for and they want you to have a good idea of the possible issues the patient could have during the treatment due to their medical conditions or medications.

3. Go through your old power points for whatever type of procedure you are doing that day!!! Whether its a single filling or something more complicated like an FPD prep, if you go through the steps and even write them down so you have an idea your step by step process, you will feel much more comfortable

4. Be prepared to not be prepared, no matter how much you prepare (LOL). No matter how much you read, study, practice in Sim Lab, talk to other students, so many aspects can end up differently than planned. Don't take it personally, don't take it to heart, don't feel like tis your fault. If you did all of the above and prepared as much as you could, thats all you can do. Its literally how our future profession is going to go every day of our lives for our whole career.

5. Related to above ^^ when you get feedback from faculty, just really try to soak it all in and learn from the experience. Write it down. If they don't love your composite prep, write down their exact comments like immediately after your appointment. Then, the next time you have that type of appointment, you can go and see what you did wrong the last time and make sure to focus on improving that aspect. Even if its not something you necessarily did wrong but they give you a cool tip like "I like to use XYZ bur for this type of procedure because ABC" and then they will show you how to use it, write that down. Soak it in. They may roast you a bit but just say "Yes sir, yes ma'am, do you have any advice or recommendations on how I can improve next time?" then like i said, write it down.

 

[Molar Whisperer]

I think the best approach is to gain confidence by keeping things as simple as possible. You can prepare for the world but rarely in clinic do things go to plan or look like in the text books. By the time you are set to see live patients, you probably passed all the pre-clinic exams and requirements. If you're lucky, try to start your restorative clinic with a simple occlusal filling. I didn't have that luxury and my first live restorative was #21 Distal class V (patient was edentulous distal on). The instructor wanted to preserve the DO marginal ridge which was the right thing to do but I've never done one. Needless to say, I couldn't get the patient numb enough and I couldn't access the cavity prep. I received an F for the day's work. Try to shadow the upperclassmen, watch YouTube videos, and keep your armamentarium as simple as possible. I noticed a lot of my colleagues have so much unused instr and supplies cluttering up (important not to waste expensive supplies in your hard earned practice).

 

[Rambunctious]

im a d2 in pre clinic and before i know it ill be down in the clinic seeing patients. I know every school is different, but what is one tip you can give to a d2 in order to be the best he can. anything i should do in preclinic in the time i have left? any time management tips? how to get as much experience i can before i graduate to feel prepared? thanks

learn how to do a lot of different procedures. dont worry about speed, you will get that when you actually start working

 

[TanMan]

As much as the above posters have great advice, they forget one thing: Find out what each instructor likes. Some have fetishes with supershiny amalgams, smooth line angles, sharp line angles, shallow isthmuses, and so on... What's a success with one instructor can be a failure with another. Doesn't matter how textbook your procedure goes, if there's something they don't like, it's still subjectively graded worse.

I find that an information bombardment and overload tends to just get them to leave you alone, finish you, and pass you. I remember one faculty that loved pediatric inlay preps, which wouldn't fly with other faculty.

 

[PerioDont]

As much as the above posters have great advice, they forget one thing: Find out what each instructor likes. Some have fetishes with supershiny amalgams, smooth line angles, sharp line angles, shallow isthmuses, and so on... What's a success with one instructor can be a failure with another. Doesn't matter how textbook your procedure goes, if there's something they don't like, it's still subjectively graded worse.

I find that an information bombardment and overload tends to just get them to leave you alone, finish you, and pass you. I remember one faculty that loved pediatric inlay preps, which wouldn't fly with other faculty.

TanMan spitting wisdom today.

If possible try to schedule your pts with more reasonable faculty, esp part time PP faculty.

I would try to ask my upperclassmen about certain faculty preferences before starting big procedures. We had a professor who would get really pissed if you didn’t introduce him to the pt by name, another who wanted you to have a photo of the prep before starting, another who wanted RMGI on everything. One wanted to look at the pt pre anesthesia and rubber dam and another who didn’t want to check anything till everything was done. So much variation, gotta learn how to play the game with each faculty so you can get out alive

 

[Rfrosty]

I don't know what type of health record system your school uses (probably aXium or some other electronic health record) but spend some time assisting in the clinic and actually watch the upperclassmen entering information (heck, ask them if you can enter it for them) and ask them what forms they're filling out, how to formulate a treatment plan and get it signed, how to get the financial portion squared away, how to write notes, and how to discuss treatments and costs with patients.

Students who spent time assisting in the clinics the most started out the strongest when it comes to communicating with patients, faculty, and taking care of the administrative stuff. You will pick up super useful tips and tricks in the clinic as you observe upperclassmen. They are probably your best resource in the clinic.

You probably already have a feel for what instruments and techniques work well in your hands. Stick with them (but be open to new things) and as some others have pointed out be organized. There should ideally be a logical layout of your instruments dictated by the sequence of procedural steps you plan to follow. A solid layout also allows you to easily locate what you need if plans suddenly change or you need to backtrack at any point. Have everything you think you'll need ready to go and everything else in your kit put away on standby.

Learn how to administer anesthesia properly and check the tooth with endo-ice if you're in doubt. Don't put on the rubber dam and then realize the patient isn't completely numb (may still happen despite your best efforts so don't be hard on yourself). This goes double for extractions. Don't start pulling the tooth out until you feel confident the patient is numb (usually tissue blanching is a good sign you're heading in the right direction). Local infiltrations are great until you're dealing with an infected tooth. Know your blocks and practice them so you're prepared for emergencies, anesthesia failures, or "a hot tooth."

Treat your patients like you would your family. Thats your mother or father in the chair, what treatment is best for them and are you completely sure you have all the information you need to make the best decision? It's fine if you don't know. You're learning. Don't be afraid to ask the faculty. I generally dislike asking questions but I've come to accept the quote--the man who asks a question is a fool for five minutes, the one who doesn't is a fool for a lifetime.

Be confident and calm or at least fake it very well until you actually are. Your patients will look to you for guidance when they're uncomfortable. Be able to walk them through a procedure with breathing exercises and assurance that everything is okay even if you have alarm bells ringing in your head, they pass out, start freaking out, or they vomit (or all four if you're really having a good day).

This list is not exhaustive by any means. I have much more to learn about everything. I'm a complete novice. But I would say that these are things that made clinic go much more smoothly/efficiently for me.