Page 131 - Demo

General discussion1297Implications for practiceIt is important to be clear about the level of competence that is to be acquired during the undergraduate training (ESE 2018), and each school should provide upto-date information about this. Although the European guidelines (ESE 2013, Field et al. 2017) state clearly what the minimum level should be, not all schools comply (Al Raisi et al. 2019). Presumably, limited time or resources are the reason for not complying. As it comes to clinical experience, the guidelines may be slightly more open to interpretation (chapter 4). To provide students with clinical experience when there is a shortage of patients who need uncomplicated root canal treatment, dental schools may decide to allow students to perform more complicated treatments (Al Raisi et al. 2019). Although students would like to gain plenty of clinical experience in performing root canal treatments of varying difficulty levels during their undergraduate training (chapter 4), this ‘solution’ is not recommended since it probably will decrease the selfefficacy of those students with no or barely any clinical experience (chapter 4). Besides, allowing students to perform complicated treatments on patients could undermine a fundamental message that practitioners should refer patients for treatments that are beyond their skill set.To build self-efficacy efficiently, students should start with performing uncomplicated root canal treatments on patients (chapter 4). Only little clinical experience before graduation seems necessary to manage to perform root canal treatments – of increasing difficulty level – in practice after graduation, and to build self-efficacy (chapter 5). Our work may bring about a shift in the opinion about the actual value of clinical experience from acquiring or testing skills in performing endodontic treatment to building self-efficacy (chapters 4 and 5). As a consequence, the simulated clinical training can be regarded as most important for both formative and summative assessment of the student’s level of competence. It is still unclear, however, whether for all endodontic treatments the required skills can currently be trained and assessed effectively in an environment that simulates clinical reality as closely as possible. We studied root canal treatments only; our findings cannot be generalized to direct pulp capping for instance. Whenever possible, skills should be trained and assessed in simulated conditions, and teaching staff should not compromise and should ensure that the required level of competence is reached before students are allowed to perform Annemarie Baaij.indd 129 28-06-2023 12:26