June 2004 • RDH Magazine

Thinking critically

Dear RDH:

I would like to comment on the "Ignorance About Preceptorship." We have been dancing with this issue for some time now and we seem to banter back and forth about "skills" and doing "prophies." What appears to be missing, in my opinion, is the most important consideration: the ability to think critically.

I believe one of the most valuable ways to learn, enhance, or promote this quality is to be questioned, repeatedly, over a period of time, about many different types of classifications of patients, regarding every aspect of care — not just the "instrumentation" aspect. There is so much more to dental hygiene care than "the cleaning." The ability to make a dental hygiene diagnosis, formulate a dental hygiene care plan, implement that plan with outstanding skill and judgment, and communicate it clearly to the patient, from a strong knowledge base, cannot be overemphasized.

How we are able to reach this point is up for debate. Working in a dental hygiene program as well as in a dental school environment, I see what standard is required and enforced by instructors and professors who do not get paid much (compared to private practice), and dedicate themselves to guiding students in critical thinking.

I am an RDH, practicing 21 years. I attended a two-year, A.S. Program in order to become a hygienist. I have been exposed to two-year, four-year, and one-year assisting, plus one year of dental hygiene programs. I cannot imagine a preceptorship program that allows one to acquire the necessary skills to think critically. It simply takes time and experience to earn and learn this skill. I can't even imagine a "gifted" preceptor-trained clinician being the type of person who would just "clean teeth."

The National and Clinical Boards are not even being mentioned in this letter; that's another situation that one can, in reality, be taught to the test. This letter is about the ability to "think on your feet," given varied situations and conditions, and knowing, and doing, what is best for the patient. All this is done with a strong sense of confidence. This sense of certainty and assuredness only comes with time, experience, and compelling questioning.

Juli Kagan, R.D.H., M.Ed.
Boca Raton, Florida

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