The use of outreach clinics for teaching undergraduate restorative dentistry

To examine the experience of being an outreach teacher of undergraduate restorative dentistry; to describe the desirable characteristics of such teachers; and to consider the management of outreach teaching.

A three year pilot of an outreach course in fourth year restorative dentistry began in 2001. Students spent one day per week treating adults in NHS community dental clinics, run by Primary Care Trusts (PCTs). Action research involved monitoring meetings with students, clinic staff (dental teachers and nurses), and PCT clinical service managers. These data are supplemented by an independent evaluation involving interviews with dental school academic staff, and an account by an outreach teacher.

Outreach is a different and more demanding context for teaching restorative dentistry than the dental hospital, characterised by isolation, management responsibility, pressure, a steep learning curve, and stress. The desirable characteristics of outreach teachers are those which enable them to cope in this environment, together with a student-centred teaching style, and the appropriate knowledge. Management of teaching passed to the PCTs and this created an additional workload for them in relation to staffing, risk, and service-based issues. Four teaching surgeries were the maximum for a satisfactory level of patient care and student supervision. A key issue for the dental school is quality. The changes to teaching and the teaching environment introduced during and after the pilot to address problems identified are described.

In developing facilities to enable students to benefit from the advantages of outreach, dental schools should recognise that the characteristics of the outreach environment need to be taken into account during planning, that staff selection is a critical success factor, and that an ongoing proactive approach to organisational arrangements and to the support of teaching staff is necessary.