Preparing students for their first surgical patient

Abstract

Performing a surgical procedure on a patient for the first time can be an intimidating experience for students, often resulting in nervousness and a lack of confidence, which affects their performance and is noticeable to patients. Despite preclinical training and testing in the lab, students continue to make similar errors in the clinic, such as incorrect positioning of the patient, the operator and the dental light. These mistakes could stem from the difference in setup between the surgical model mounted on a lab table and the clinical chair.

Preclinical training was shifted from the lab to the actual clinics, with the same surgical model being now strapped to the dental chair. After the demonstration of the surgical procedure, students practiced under faculty supervision and received feedback. A structured, step by step, evaluation form with rubrics was developed and peer-reviewed to assess their ‘Readiness to safely perform tooth extractions’. This form was shared with students to help them prepare for a practical exam. The steps assessed included proper positioning of the operator, patient and light to ensure visibility and access. These were common mistakes observed in the past, and by assessing them, a measure of improvement in student performance could be observed. Following the ‘readiness exam’, a survey was sent to all students using Google forms for feedback, and the results were tabulated.

Analysis of student feedback and their test performance revealed valuable insights into student learning, preparedness and achievement of learning outcomes. One student commented, ‘The practice session simulating a real patient was amazing and boosted my confidence for my first patient.’ Another remarked, ‘It helped me understand the positioning of the patient and operator, adjusting the light, and arranging instruments—things we couldn't practice appropriately in the lab.’ A third said, ‘The readiness exam was excellent for building confidence, preparing for real patients, and learning from our mistakes.’

Faculty observed that training and testing in the actual clinical environment improved student performance, reduced common errors and increased confidence for their first surgical procedure. Clinical time with patients was used more efficiently, since time was saved not having to repeatedly correct basic positioning errors.

Moving training from the labs to the clinics replicates real-life settings, and this along with having a rubric-based readiness test shared ahead of the exam with the students enhances learning in a safe environment, building student confidence without compromising patient safety. Although replicating a clinic around a training model is costly, transferring the model to the clinic involves no financial cost, only challenges with logistical arrangements and clinical scheduling management. The improvement in student performance, confidence and clinical readiness is well worth the effort. Health care educators whose students face patients for the first time after preclinical training should consider training, transitioning from the lab to the clinic and should explore ways to overcome the challenges of transitioning, to better prepare students for working with their first patient.

Faiyaz Syed Ahmed: Conceptualization; data curation; formal analysis; investigation; methodology; visualization; writing–original draft; writing–review and editing.