Dentistry is in a constant state of flux, with techniques, materials and recommendations continuously evolving. Moreover, there is an individual journey to be made by each aspiring dentist, whether you are a diligent undergraduate student or an independently competent dentist.
Whilst the hands-on aspect of dentistry is rigidly taught, the softer skills such as professionalism are harder to teach and assess. Comparing the two skills, should we therefore expect a dentist to constantly seek to improve their professionalism in the way that they would a clinical skill?
Ethics and professionalism
First and foremost, it is important to recognise that professionalism is an aspect of dentistry that is open to a degree of interpretation. Plus, despite the provision of documents by the General Dental Council (GDC) on the matter, and its attempts to outline what professionalism means in the practice, there is actually no definitive, quotable definition available to the profession (General Dental Council, 2013).
Naturally, however, there are some clear expectations from governing bodies and patients as to what professionalism entails, including expertise and skill mix, respectability, responsibility, reliability, integrity and ethical values.
To me, the latter plays a particularly important role in professionalism in dentistry, as ethics is about doing the right thing when nobody is watching. Consequently, if ethical practice is a moral duty, it could be argued that it reflects a person’s own idiosyncratic principles. However, like professionalism, an ethical response cannot be taught, which is why in many ways the two are intrinsically linked.
To fully comprehend what the term means, it is important to consider professionalism with regard to patients, to self and to the clinical team and peers. For instance, a professional should promote a successful relationship with patients and encompass a model image and behaviours.
Moreover, I believe that the standards outlined by the GDC should be reflected within the delivery of patient care, including putting patients’ interests first, respecting patients’ choices, maintaining confidentiality, maintaining professional competence and implementing a multi-disciplinary approach where needed – if it is in the best interest of the patient.
It is also pertinent to note that patients also have individual perceptions of what it means to be a professional and what they expect from a service. Indeed, in addition to expected behaviour and language, appearance is highly valued too (Brosky et al, 2003).
Sense of self
In regard to self, I would argue that professionalism is a broad competency needed by dentists to act effectively, acceptably and ethically, and is therefore paramount to both undergraduate and postgraduate curricula. Indeed, as an undergraduate dental student myself, I recognise that professionalism is an essential competence for a successful career.
However, there is a paucity of explicit teaching and assessment within the undergraduate curriculum. Whilst all dental students seek to act professionally, there is a sense of assumed competency and of ‘playing a role’, as well as a perception that with increasing clinical competence comes greater professional competence.
The reason behind this may be due to the increased acceptance of responsibility and accountability. Thus, whilst the ideology and core principles of dentistry such as altruism, honour and integrity are constants, perhaps there is scope to bring individuality and flair to professionalism.
What’s more, as there is no single instrument yet to measure professionalism, and it is possible that the most accurate assessors are actually the patients themselves; I think it would be prudent for students and experienced professionals alike to regularly seek feedback from the patients they treat.
To a certain extent, feedback from peers and other members of the clinical team could also be beneficial, but it could also have a negative result, especially if a colleague has a different view on what it means to be a professional.
In essence, professionalism is essential to the practice of dentistry, yet paradoxically is difficult to define, teach and assess. I have also found through my undergraduate education and personal experiences in the practice that it is important that a budding dentist transfers the commitment of lifelong learning to the softer skills in dentistry, remaining committed to continuous personal and professional development.
Furthermore, I think that it would be judicious for dentists to obtain regular feedback, so that the profession remains receptive to patients’ needs and instils trust in modern dentistry.
Brosky ME, Keefer OA, Hodges JS, Pesun IJ, Cook G (2003) Patient perceptions of professionalism in dentistry. J Dent Educ 67(8): 909-915
General Dental Council (2013) Standards for the