Open - HETI - NSW Government

The educational roleCase studies: Developing clinical skillsTeaching a surgical skillA twenty nine-year-old patient is booked in for removal of a partially erupted third molar tooth.This is the first time the junior clinician is performing this surgical procedure. The senior clinician elicitsfrom the junior clinician the steps involved in the process and discusses the surgical flap design andthe plan to remove bone around the tooth to simplify its removal. Drawings have been usedin the discussion to clarify points for possible bone removal, sectioning of the tooth, good positionfor elevation of the tooth parts, and warnings about areas of risk to the patient during the procedure.The junior clinician learns the importance of simple surgical techniques, the risks to the patient,and is informed of conditions when the senior clinician may need to assist.The senior and junior clinicians together explain the process to the patient, discuss the risksassociated with the surgery, and complete the patient’s request /consent for the treatment.The surgical procedure is carried out and the junior clinician is guided through the processby the senior clinician.Outcome: The junior clinician has learned the simple aspects of the surgical procedure, has sharedand practised communication and the consent process with patients, and has satisfactorily completedthe surgical removal of a partially erupted third molar tooth.Teaching a diagnostic skillThe supervisor has a discussion with a junior clinician/student about the questions used to diagnosea patient who attends with pain. A problem-based learning process is introduced to the discussionalong the following lines: What are the diagnostic clues you looking for in the answers you get froma patient when asking the following questions:• Does it hurt when you eat or bite on the tooth?• Do you feel pain with sweet, hot or cold?• When you feel pain with hot or cold how long does it last?• Is there anything you can do to make the pain subside?• Does the pain wake you during the night?46 HETI The Superguide FIRST EDITION