Page 90 - Demo

Chapter 588findings from the present study may suggest such a positive effect, it was not statistically significant. Besides, when a colleague helps to overcome a difficulty, this does not necessarily contribute to the novice dentist’s feeling of being capable of performing a similar difficult task without any help. The novice dentist may give the credit to their helping colleague instead of to themselves when appraising their performance. A reason that the novice dentists in Denmark performed more root canal treatments and referred less in comparison to the novice dentists in the Netherlands might be that there are less referral possibilities for a root canal treatment in Denmark. Ideally, a practitioner should refer a patient when they lack the necessary skills to perform the indicated treatment themselves. A practitioner may also decide to refer when they believe that they lack the necessary skills, regardless of whether that belief is accurate or not. Such belief may be reflected in lower self-efficacy; the novice dentists with low self-efficacy may overrate required skills, or doubt their own skills (Gist & Mitchell 1992, Wulf et al. 2010). Those skills might include not only the skills in performing different types of endodontic treatments, but also the skills in diagnostics and treatment planning. Decision-making is influenced by the practitioner’s knowledge and confidence in treatment options (McCaul et al. 2001). Self-efficacy influences individual choices and outcome expectancies and might also be a factor influencing the choice of treatment (Bandura 2006, Gist & Mitchell 1992). Self-efficacy, however, is the belief that one will be able to successfully perform the treatment regardless whether that treatment in itself will lead to a good prognosis or not (i.e. regardless of the outcome expectancies), and it should, therefore, not necessarily influence the treatment choice. In the interest of the patient, the choice of treatment should be based on outcome expectancies that are based on evidence. The novice dentists in the present study were not educated to the level of competency to perform endodontic surgery on patients during their undergraduate education. It is therefore expected that the participants referred their patients when they selected this treatment option. Novice dentists with more experience and higher self-efficacy decided more often to refer for endodontic surgery. They may have had a more realistic perception of their skills as well as of their limits, and may make a more realistic distinction between operatordependent factors and what the external factors contributing to the prognosis are; their high self-efficacy may remain high even if they have to refer a patient because the treatment that they had performed appears unsuccessful (Gist & Mitchell 1992, Ng et al. 2011). One might speculate that the choice of treatment Annemarie Baaij.indd 88 28-06-2023 12:26