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General discussion1237is a gap of approximately two years between the simulated clinical training and the moment students start performing root canal treatments on patients. Ideally, students start with providing endodontic care to patients once they have acquired the required competencies, and continue to provide endodontic care to patients regularly. When there are not enough patients available who need endodontic care of a suitable difficulty level for the students to build self-efficacy and ensure continuity, students should regularly perform endodontic treatments in simulation and discuss cases. That the acquired skills should be employed regularly applies also for students who have not yet reached the required level of competency to treat patients. Also the gap between the simulated clinical training in the fourth year of ACTA’s curriculum and the preceding theoretical and preclinical training in the second year is too large. Students feel that by the time they receive the simulated clinical training, all the skills and knowledge they had acquired earlier have faded away (comments in questionnaire used in chapter 4). Consequently, the simulated clinical training functions mainly as a refresher training instead of serving as an additional training to acquire advanced skills. This is quite unfortunate, especially because within the undergraduate curriculum the time dedicated to Endodontology is limited. It is even considered too little according to students of ACTA (comments in questionnaire used in chapter 4). Within the undergraduate curriculum of ACTA, the time dedicated to Endodontology will increase in the coming years. However, probably not every dental school has the possibility to increase the time dedicated to Endodontology when that is desirable. The education in Endodontology may be more efficient and effective when it starts not in the second year but in the third or the fourth year of the curriculum and when continuity in practising Endodontics is ensured. This way, not only skills retention will probably improve, but also a higher level of skills might be acquired. Culture Most novice dentists in the Netherlands work in group practices (chapter 5), probably because of the presence of other – more experienced – dentists. However, the availability of help from colleagues was not associated with an increase in the novice dentist’s self-efficacy (chapter 5). Besides, when novice dentists referred their patients for endodontic care, it was in most cases not to another general dental practitioner. For root canal treatment, retreatment, care Annemarie Baaij.indd 123 28-06-2023 12:26