Here is an eloquent editorial from the new Dean of PENN Dental: Marjorie Jeffcoat who is also Editor in Chief of JADA: Journal of American Dental Association. Every aspiring Dentist and Dentist should read this.
VIEWS
Mens et manus
Striking a balance between skill and reason
MARJORIE K. JEFFCOAT, D.M.D. EDITOR
E-mail:
[email protected]
An unthinking dentist is a bad dentist. Perfect technique misapplied is at least as unconscionable as sloppy work.
The humble Latin words ?mens et manus? (?Mind and Hand?) appear on the seal of my undergraduate college. If you recall your own school motto, chances are it embodies high academic principles that Aristotle himself would approve: usually truth, knowledge, wisdom and virtue, in various combinations and languages. This one, though, expresses a view of higher education at once modern and quintessentially American: that an educated person should know not only how to think, but also how to do something useful with his or her education.
Few professions embody the mind/hand duality as clearly and literally as dentistry. In the public mind, the dentist is right up there with the neurosurgeon in the pantheon of manual dexterity, and deservedly so. An unskilled dentist can?t be a good dentist?a gifted lecturer, perhaps, or a great researcher?because the profession inherently demands technical excellence. But it?s just as true that an unthinking dentist is a bad dentist. Perfect technique misapplied is at least as unconscionable as sloppy work.
Are we maintaining the balance between mind and hand? I?m not entirely sure. On the one hand, I believe that today?s dentist is both better educated and more sophisticated than his or her counterpart a generation ago. Our schools are generally teaching very up-to-date scientific material. The literature has never been more abundant or readily available. Quality continuing education is universally accessible. In my experience, most dentists are making good use of these resources to keep current and sharp.
EDITORIAL
On the other hand, we find ourselves working in an environment vastly more demanding in almost every way. We are seeing more elderly and medically compromised patients, for whom our understanding of drug interactions is more important than any mere procedure. With new techniques and materials arriving on the scene every day, we need to make rational decisions as to whether, and in what circumstances, to use them. Helping a patient decide among multiple treatment alternatives can be a challenging exercise in logic and communication.
To keep our bearings amid these shifting currents, our best compass is a habit of critical thinking. We can?t question everything?that way madness lies?but a regular internal dialog with a skeptical alter ego helps keep things in balance. Why do I do a particular thing in a particular way? Does this journal article pass the test of clinical plausibility? Exactly how will the new software improve my practice? Can I trust the authors of that study to have done it properly and to have reported the results fairly? Beware, though, of reserving your critical faculties only for new ideas; you should be equally hard on the old, familiar ways, which may be overdue for a change.
Critical thinking is something we can all do if we try, but it needs to be second nature, an automatic way of looking at things, if mind and hand are to be equals. It?s a habit that should be firmly established in dental school and made relevant across all subject matter. Sometimes I wonder if our schools are on the right track here.
For more than a century, and certainly since the Gies report of 1926, dentistry has been recognized as a ?learned profession,? and American dental schools are full citizens of their parent universities. Yet it can?t be denied that dental education is fundamentally different from mathematics or biology or even medicine. Most obviously, a dentist is qualified (and expected) to deliver independent patient care immediately on graduation. This stark reality drives dentistry toward curricula packed with facts and techniques, with limited time for reflection.
While acknowledging these constraints, I?m convinced that we teachers could do a better job of preparing our students for a lifetime of difficult decisions. The first step is to gain agreement that critical thinking is a central organizing principle rather than an isolated, and peripheral, elective. From there, we can proceed to redesign our courses so that the material is presented not as settled doctrine, but as a snapshot of a work in progress. Utopian that may sound, but it can be done and is being done, here and there, without compromising skills in the least. It just requires commitment.
I started with a Latin phrase, and I?ll close with another. The Royal Society of London has, for almost 350 years, proclaimed ?nullius in verba,? which I personally paraphrase as ?show me the data.? That?s a pretty good rule in itself. But the original line from Horace, from which the phrase was drawn, is even more apt: roughly, ?I am not bound to accept a thing merely because my master says it is so.?
If more dental schools took this motto to heart, they would be much more vibrant?if less placid?places to educate the next generation.