Patients open up about dentists’ treatment

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By Heather Travis
Thursday, January 21, 2010
Sitting in the dentist’s chair can be an emotional experience for some people.
 
 
Barry Schwartz, assistant professor for the Schulich School of Medicine & Dentistry, is giving patients a voice in the future of dental treatment.  Through a new project funded by the Fellowship in Teaching Innovation, Schwartz is giving students a glimpse into how dentists are perceived by their patients in order to teach them empathy and ethics.
 
 
 
 
 
 
They may fear the buzz of the instruments, worry about discovering cavities or feel anxious about forgetting to floss. 

From the moment they sit down, tilt their head back and open wide, most people are counting the minutes until the dentist hands them a new toothbrush. Few patients are given an opportunity to tell their dentist what they think of their treatment, access to care and whether they felt marginalized.  
 
While students in the dentistry program at the Schulich School of Medicine & Dentistry learn the technical aspects of becoming a dentist, assistant professor Barry Schwartz is teaching them lessons in empathy and ethics through the voices of potential patients.
 
“I learned more from my patients than I did for my patients,” says Schwartz.  
 
Along with Dentistry’s Assistant Director, Academic, Richard Bohay, and Clinicial Skills Learning Program manager Judy McCormick, Schwartz is this year’s recipient of the Fellowship in Teaching Innovation.
 
The fellowship, provided by the Teaching Support Centre, supports the project entitled: “Evaluating the Introduction of a Patient’s Voice in Dental Education Through Reflective Experiential Learning and Self Reported Changes in Empathy.”   Studies have shown empathy with dental patients diminishes from the first day dental students begin their studies to the day they graduate, says Schwartz.  
 
“They become jaded by the things patients say and the things patients do,” such as missing appointments or lying about personal dental care, he says.  
 
The ability for dentists to improve interpersonal relationships with patients is key to enhancing patient care and building trust, which can influence patient loyalty.  
 
No other dental school in Canada uses patients as teachers to enhance these skills.
 
“I challenge them to look at things from their perspective and the patient’s perspective. And, I hope that at the end of the day they would see that there’s an opportunity to be moved by an experience that a patient has shared with them and to be a better dentist for it.”  
 
Schwartz filmed interviews with 19 patients representing a spectrum of interests, including those who are socio-economically challenged; those with mental and physical disabilities; and patients who are HIV-positive. One interviewee is also the subject of a case study in the course, an example of a patient fired by a dentist.
 
Interview subjects were asked to reveal their experiences, both positive and negative, as well as their opinions of the profession.
 
The interviews are played for students in class and they are invited to participate in discussion. For example, one interview subject discussed feelings of being judged as a person who is HIV-positive.  
 
Dentists need to see their patients as more than a treatment; by understanding the whole patient and treating them in a respectful, non-judgmental way, dentists can better serve them, he says.  
 
Schwartz hopes students will use what they talked about in the class to shape their decision-making process.
 
“If we don’t flush it out here, then where?” says Schwartz.
 
“Professional maturity is developed regardless of their training; it’s just how quickly they learn it and how many mistakes they make along the way ... I would like the students not to have to learn that way.”  
 
The students fill out a survey both pre- and post-intervention. These, along with students’ reflective journals, will be analyzed to determine the overall impact of this teaching method on students’ level of empathy towards patients.
 
Schwartz began the project in May 2009 and is still collecting and analyzing data. If the program is successful, the team plans to introduce similar videos for other areas of dentistry, including endodontics (root canal), periodontics (gum treatment) and oral surgery.
 

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