A comprehensive care clinic in Swedish dental undergraduate education: 3-year report

In 1993, a new undergraduate curriculum was introduced at the Faculty of Dentistry, Karolinska Institute. The expanded comprehensive care clinic described in this 3-year report, is proposed as a potential model for a CC-clinic in dental undergraduate education. Students enter clinical training at the beginning of the 3rd year and continue through to their final semester, in the 5th year. The one student is responsible for the total oral care of all his/her patients. Patients are stratified on admission into 3 levels, depending on the complexity of treatment need. Before being assigned their 1st patients (patient level I), the students must fulfil specified requirements of theoretical knowledge and clinical procedures and obtain a proficiency certificate. After qualifying for higher proficiency certificates, denoting their level of clinical responsibility, the students assume successively greater responsibility for treatment of patients, with less supervision from clinical instructors. Clinical supervision is the responsibility of integrated multidisciplinary teams of faculty members. Each group of students is assigned a clinical tutor, who is responsible for overall treatment planning of their patients. The individual student's clinical progress and achievements are monitored by a specially designed computer program. Criteria for a final pass in the course are: (1) clinical maturity in overall patient management; (2) technical competence in conjunction with theoretical knowledge. 3 years experience of the new model for comprehensive clinical training in a patient-centred, multidisciplinary clinic has shown that; (a) students seem to acquire a greater understanding of comprehensive case management; (b) patients receive more co-ordinated care; (c) there has been no significant change in the number of clinical procedures completed; (d) difficulties arise in co-ordination of staff over the traditional specialist boundaries; (e) assessment of student maturity and professional responsibility is impeded by the lack of objective criteria.