Selecting appropriate patients is a key factor in the clinical licensure examination process. Throughout the exam process you will be evaluated on your ability to identify the criteria and recognize conditions in your patient.
Let's examine the following scenario:
Candidate "Joe" spent all day screening patients for his upcoming clinical board exam. He found a total of three patients—two he felt comfortable treating and one who was questionable. Joe asked a faculty member if he thought the questionable patient met the exam criteria. The faculty member acknowledged that patient met the requirements. Joe was relieved—he had secured three patients for his clinical board exam! After Joe received patient consent, he explained to his patients that he would make their travel and lodging arrangements for the exam. He provided the patients with the address of the exam site and briefed them on when they should arrive.
On the first day of the exam, Joe's perio patient didn't show up as scheduled and his amalgam patient was rejected. What could have Joe done differently to prevent this situation?
The answer: He could have taken the time to study the published patient criteria, clearly communicated vital information to patients, and used an organized and well-planned system. .
Study the exam patient criteria and make sure your patients meet all the conditions. If you are not sure whether or not your patient meets the criteria, it's likely that the patient doesn't. Look for "virgin" lesions that definitely penetrate "to" the dentino- enamel junction (DEJ). Beware of lesions that have a significant shadow beyond the DEJ. A small notch or "wedge" (only 1/3 penetration), may not be acceptable.
Trust your comfort level
Choose patients with conditions you feel comfortable treating. Meeting only the minimum criteria can result in patients being rejected. Also, don't rely on others, even faculty members, to select or qualify your patients. Board examiners will determine the final acceptability of your patient. Having a back-up patient who is readily available is a very good idea.
Remember that your patients are patients (not dentists)
Communicate essential information to your patients to alleviate confusion. Explain in detail the procedures you will perform, what the examiners will check and how many examiners will review the graded procedure. Be sure to explain that the examiners are not at liberty to comment on the quality of treatment, and therefore examiners may avoid questions or conversation.
Give them the facts
Be sure your patients know your name, candidate number, the name of your assistant and exactly when and where to meet you. If necessary, arrange transportation for your patients to the school. It couldn't hurt to type all this up in an instruction sheet.
Inform your patients of the overall time commitment and clinic conditions prior to exam day. Suggest that they bring some reading materials since there are often long waits in the examining area. Inform them that the clinic floor and examining area can get chilly and they may need to bring a sweater or jacket. Finally, offer your patients something to eat and/or drink throughout the day to make sure they're comfortable.
Be honest and appreciative
Before you begin your exam, remember to express your appreciation and remind your patients that their behavior is important to your professional future. Let them know that their participation makes it possible for dentistry to maintain high standards of competency.
Finally, remember that communicating crucial information to your patient can be just as critical as the patient selection process.