Students Practice Room Rules at Semmelweis University Department of restorative Dentistry and endodontics
The Semmelweis University’s Restorative and Endodontics Clinic, in its most important objectives as a teaching and healthcare institute, so as to provide clinical care of the appropriate level to all citizens, strives to carry out training which is continually accessible and provided without discrimination. The Dental Department passes on technical skills in small groups through ongoing practical training during which students carry out dental work themselves with the help of, and under the supervision of, the department’s dental instructors. In view of this distinctive environment, a regulated system for the handling of patients by students is necessary.
The goals and basic principles encapsulated in these rules aim to help students, carrying out clinical care, in their study, in performing practical medicine and to give guidance on how to work together as true partners with health personnel and patient. Students who follow this set of rules and keep to them during their studies will find this reflected in their dental practice marks at the end of the term.
- The student arrives precisely on time, well groomed and smartly presented as befits a doctor, tidily dressed in a completely buttoned-up white lab coat marked with „H”, for students. Long hair must be tied up. Realizing infection control is highly important (no jewelry under gloves, no colored nail polish!).
- During treatment it is not acceptable to eat, to chew gum, to use a mobile telephone, or to talk loudly.
- The half-year will count as valid towards final qualification if the head of practical training scores a grade for the student’s performance of ’pass’, or better. This must be achieved during term time, and there is no way to substitute for this practice.
- In the course of the semester a maximum of three absences is acceptable. Any more absences than this and the half-year cannot be accepted.
- The student must be diligent and motivated. In preparing for the vocation of clinical practice, every session must be adhered to so as to build up technical proficiency.
- The student is ready with the correct documents for the day and
- must have a thought-out treatment plan for the patient organised.
The first session of treatment always begins with a general and dental medical history, intraoral examination, establishment of a diagnosis, advice on oral hygeine, and establishment of a treatment plan, then the first intervention – with the exception of patients in need of urgent first aid – then continuing with scaling and oral hygiene treatment. This often happens in several clinics in parallel. Treatment at other institutes continuing parallel with our own must be organised and directed by the student with the teacher’s assisstance. Assistance in instruction and direction are obligations of the student.
- Theoretical background knowledge of the planned treatment is desirable. The student must know clearly at every step of the treatment he is carrying out. Without this, treatment is not possible!
- Knowledge of the material in the department’s lectures is indispensible, and students must be prepared for oral or written examinations on this material.
Communicating with patients
- The student must manage the registration of the patient at reception and recalls for the next appointment.
In the interest of effective patient reception the patient must know the names of both the student treating him and the student’s instructor. Because of this, these names must be written legibly on the index card along with the exact date, time, and practice room number for the next appointment. The student must also call the patient’s attention to the fact that at the downstairs reception it is important that the patient makes sure he is registered to the correct clinic in the computer. At the same time the student dentist must update the patient contact information, so that he can be informed in case of any change. It is only possible to treat patients who have been signed in on the computer system, and the student must check this before beginning treatment of the patient.
- It must be emphasised by the student that prompt attendance at the agreed appointment for treatment is important for the patient also. And it is not only in the patient’s interest but also the student’s, that repeatedly being late or no advanced notice on abscence by the patient may disrupt the student’s practical work; at these times he should see to signing in other patients.
- The student must put major emphasis on instructing and motivating the patient.
- Time must be devoted to correctly informing the patient, explaining the planned treatment, and clearly stating the procedures, the outcomes, and also the possible complications.
- The student is obliged at the completion of the semester to continue with any treatment necessary to the patient (himself continuing the treatment in the subsequent semester, or during the summer session, or handing the patient over– if this has been previously discussed and arranged – to colleagues).
- Use of gloves and face mask is compulsory while treating patients, for which the clinic will ensure sufficient supply of gloves and masks to everyone. The number of glasses and plexi shields is limited, and so it is recommended that each student obtain these for himself. Use of turbines or scalers without eye protection is not permitted!
- The student gets a sterile tray of instruments for each treatment. Sterile pouch removed from the tray must be placed into the black bins supplied for communal waste disposal.
- The student must collect all items needed for the treatment. Necessary materials, instruments in many cases have to be requested from assistants. In the interest of keeping to the hygiene regulations, no-one apart from the assistant may have access to cupboards or storage areas!
- The movable sidetable on wheels should be used as a working area for the endodontic tray or the impression tray, etc. The shelf beneath it is for holding the student’s personal notes, the patient’s index card, and the lowest shelf is for storing the patient’s personal belongings. (Patients’ coats and larger bags should be placed in the cloakroom – they must be reminded of this!)
- The student must not touch telephones or computers with their gloves on, similarly record cards must be handled only after removal of gloves, with bare hands.
- Waste created during treatment of the patient (cotton rolls, rubber dams), materials stained with blood or saliva (masks, gloves) must be handled as dangerous waste, and must be thrown into rubbish containers marked with special labels and lined with yellow bin bags.
- During endodontic treatment it is neccessary to make a needle control X-ray. After registering the measured data the student and the practice instructor accompany the patient to the scan. In these cases the student takes instruments on a covered tray with him. Door handles must be touched without gloves on or else using paper towels. The actual taking of the X-ray is the task of the practice instructor. Nevertheless students must understand and know the aims of needle control, the method of implementation, and actively assist in the preparation of the patient’s radiograph.
- The student must strive to ensure the transparency of the work table, the cleanliness of the work area, keeping to the instructions relating to infection control among health personnel!
- There must be attention given to avoidance of injury: eg. removing burs or scaling tip from the handpiece after use and placing them on the tool tray. Sharp, piercing waste items (needles, syringes) can only be disposed of in hard-walled waste bins labelled as containing dangerous waste, so as to avoid accidental injury to anyone (eg. during rubbish collection or storage).
Carrying out practical sessions
- In our clinic we teach a work method where the patient is seated on the dental chair in the reclined position, and two students are always present i.e. one working and one assisting. We referr to this as a four-handed treatment. To make this work, students in practice work in pairs. Both the dentists’ tasks and the work done by the assistant working next to the dental chair must be mastered. Because of this students must take care to divide up their time fairly.
- Knowledge of the correct use, preparation of, and indications for handling of instruments and materials necessary for treatment is a basic requirement.
- The student must be familiar with the material names, compositions, and the instructions on how to employ them correctly.
- An important requirement is thrifty, economical use of materials.
- Similarly important is the protection and careful use of dental instruments, avoiding injury. However, whatever is dropped, broken, or bent, the student must not be embarrassed to call on help from the assistant.
- It is obligatory for the student to show tooth planned for treatment, to show each work phase (eg. preparation, isolation, placement of the matrix, etc) and the completed work to the practice instructor before patient leaves.
- The student cannot discharge the patient without the knowledge of the instructor!
- The student must strive to complete the treatment – to the full extent of his abilities – in the best way possible.
- The student must take the trouble to assess the necessary time for the treatment, and keep to limitations on time. Work must be finished within 5 to 10 minutes before the end of the practice session.
- The degree of development seen during the semester is an important measure in the practice grade given.
- At the first session the patient fills out a medical history page and an agreement, and authorises it with a date and a signature.
- The student is obliged to document the necessary information and details of interventions completed in the course of the treatment in the patient’s file, and ensure that this is authorised by the practice instructor.
- Computer and paper-based referrals for X-rays are requested beforehand. These are taken by the third-floor Radiology Department.
During the practice sessions
- The practice instructor checks documentation in the patient file and that it covers every moment of the completed interventions in the order of treatment. After the practice session an entrusted colleague enters all this information without any gaps into the computer. This administration is the basis for calculations between our clinic and the OEP (National Health Fund). Because of that this entry must be accurate, true, and without any missing data for the database. Time must be found for this necessary paperwork, therefore – keeping this in mind – treatment must be completed 5 to 10 minutes before the end of the practice session.
- Only with punctual departure is it possible for the assistants to ventilate, disinfect and prepare everything for the following practice session before the arrival of the next group.
On all the premises of the Department of Restorative Dentistry and Endodontics, including the practice rooms (111,113,114) it is OBLIGATORY to wear individual, personal protective equipment (single-use gloves, facemasks) during patient treatment. The before metioned equipment are ensured to everyone by the clinic. During practice it is FORBIDDEN to treat patients and to assist while patient treatment without these protective equipment. Colleagues and students not following the rules of personal safety are not allowed to take part in practice, in treatment of patients or in assistance.
I ask and wish, that by keeping to these rules, you spend your practice time at the Department of Restorative Dentistry and Endodontics usefully, meaningfully and with enthusiasm.
Dr. Vág János
Director of the clinic