Student case studies
Our case studies relate to Standards for the Dental Team from a student perspective.
Would you know what the right thing to do is in each situation? How would you respond? See what each student chose to do, what support they received and what happened next.
You can also find out more about the Standards by using our Focus on Standards resource. This contains case studies, scenarios and FAQs about how to apply the Standards in practice.
Principle 1 - Put patients' interests first
Matt
Matt is a dental student in the final year of his course. An elderly patient has complained that she felt she was being patronised and assumptions made about her choices during the three appointments he provided treatment.
Student dentist
Matt has been providing treatment for Margaret, a 75 year old patient. There were no issues with the clinical treatment that Matt had carried out, and which was of a good standard. Margaret appeared upset at the end of the last appointment. The supervisor noticed and asked how they could help. Margaret reported that, “throughout all of the appointments Matt had spoken very slowly and patronisingly to her and hadn’t fully explained the treatment.”
Margaret was reluctant to say anything further but did after reassurance from the supervisor. She felt as though she was being treated like a second class citizen due to her age, despite being an articulate, active woman with no hearing problems. She also reported that, “he talked over her and didn’t listen to what she was saying.” After the appointments he ignored her in the corridors on the exit to the clinic.
Matt’s supervisor looked at his student record and noted that this wasn’t the first time an older patient had reported this. The supervisor raised the issue with Matt who seemed surprised there had been a complaint and was dismissive.
What do you think Matt should do next?
Select an option:
- Try and avoid elderly patients in the future and perhaps think about providing treatment for mainly younger patients?
- Explain to his supervisor that Margaret was a rather anxious patient and that it wasn’t a big problem?
- Apologise to the patient and reflect on his practice?
See what Matt did next...
Matt was very defensive about the complaint. He thought he had provided good quality treatment and felt that some of the elderly patients were ‘worriers’ and over-sensitive. He conceded it wasn’t the first issue there had been with appointments with elderly patients but that he had apologised the previous couple of times and done well in an essay on discrimination and that put a line under things. What was important was how well the treatment had been carried out.
As Matt was a fifth year student he would be expected to have a well-developed approach to patient interaction and good awareness of how to treat patients from different groups. He would also be expected to have developed his reflective practice and demonstrate appropriate responses to patient feedback. The supervisor took the previous incidents into account, the lack of Matt’s insight and recognition of the importance of the patient’s needs and called Matt’s student fitness to practise into question.
Matt was required to cease seeing patients for a short period and complete further study on professionalism, discrimination, reflective practice and communication. Matt apologised to the patient who had subsequently written a letter explaining how his treatment of her had made her feel. Matt was then assessed to ensure he was ready to start treating patients again before undergoing a period of increased supervision.
GDC principles
1.1 Listen to your patients
1.2 You must treat every patient with dignity and respect at all times.
1.2.1 You should be aware of how your tone of voice and body language might be perceived.
1.6 Treat patients fairly, as individuals and without discrimination
Also...
5.1 Make sure that there is an effective complaints procedure readily available for patients to use, and follow that procedure at all times.
5.2 Respect a patient’s right to complain.
5.3 Give patients who complain a prompt and constructive response.
Other guidance
Our complaint handling best practice can be found here.
Discussion points
- Think about patients you have provided care for – are you confident that you treated them as you would want to be treated yourself? If not why not and how would you change what you do next time?
- Why do you think Matt was defensive about the complaint?
- How do you think you can deal with complaints without becoming defensive?
- How difficult do you think it is emotionally for a patient to make a complaint?
- What might be the repercussions of a complaint for; the patient, the student, the training provider?
Disclaimer
These fictional case studies are for illustration purposes only and should not be relied on to make clinical decisions. Their aim is to put GDC guidance in context, exploring how some of the principles might work in practice.
The case studies cannot be relied on to be clinically accurate. Nor do the case studies intend to show the "correct" interpretation of GDC guidance, only one (or more) possible interpretation(s).
Principle 2 - Communicate effectively with patients
Roisin
Roisin is a student dental hygienist on a work placement. She has made good progress on the course. She struggles with some of the more ‘direct’ patients with a different cultural background and can often be rude in response. Today a couple of them have complained.
Student dental hygienist Roisin is in the first year of her training programme. She has found it very stressful dealing with some patients who are more direct than others when describing their issues and decisions about treatment.
To Roisin these patients seem to come across as quite demanding and critical. This makes her feel defensive and she doesn’t quite know how to deal with it. She sometimes appears rude when she responds.
Two patients complain that Roisin has been dismissive and brusque during their treatment. Roisin is used to getting on well with most people and feels very upset. She is also worrying about how well she is doing on the course.
What do you think Roisin should do next?
Select an option:
- Wait and see if things improve?
- Try and avoid these patients?
- Speak to her supervisor and ask advice?
See what Roisin did next...
Roisin spoke to her supervisor who had made it very clear that students were welcome to approach them at any point with any problems they had. She explained how stressful it was when she felt people were rude. Roisin felt she was a student and doing her best and that she wasn’t sure how to deal with it. Her supervisor was able to explain some of the cultural differences, communication styles and expectations these patients may have. They were then able to look at appropriate responses. Her supervisor offered some extra training and support during appointments with patients and they agreed to review things in a couple of months.
Roisin felt reassured and supported. This helped her understand more about the variety of patients in the population. Roisin had asked for support when she felt she needed it and demonstrated professionalism. Although there had been a couple of complaints Roisin had recognised the issues, shown insight and was proactive in trying to address them. No concerns were raised about Roisin’s student fitness to practise.
GDC principles
2.1 You must communicate effectively with patients – listen to them, give them time to consider information and take their individual views and communication needs into account.
2.1.1 You must treat patients as individuals. You should take their specific communication needs and preferences into account where possible and respect any cultural values and differences.
Other guidance
Ask your training provider if there is any other guidance or information they would recommend.
Discussion points
- Have you ever felt it was difficult finding the right communication approach with a patient? What did you do?
- Who else might Roisin have asked about cultural differences and how to communicate with people from different cultural backgrounds?
Disclaimer
These fictional case studies are for illustration purposes only and should not be relied on to make clinical decisions. Their aim is to put GDC guidance in context, exploring how some of the principles might work in practice.
The case studies cannot be relied on to be clinically accurate. Nor do the case studies intend to show the "correct" interpretation of GDC guidance, only one (or more) possible interpretation(s).
Principle 3 - Obtain valid consent
Meiying
Meiying is a dental student in her fourth year of training. She has seen a patient requiring a filling and had the appropriate discussions with the patient about the decision to proceed with their choice of filling. At the next appointment the treatment takes place but the patient is unhappy with the amalgam filling stating that they had changed their mind.
Student dentist Meiying has followed the correct process for discussing the treatment options and gaining consent in the first appointment and has recorded the discussion and option chosen. In the time between the first and the second appointment the patient has thought more about the materials and wanted to change to a white composite filling. During the second appointment Meiying feels under time pressure to complete the filling as she has taken longer than expected with the previous patient.
What do you think Meiying should do next?
Select an option:
- The patient has given consent so go ahead with the filling.
- Explain to the patient what they had chosen last time and then start the treatment.
- Check the patient is still happy with to go ahead with the treatment and ensure consent is still valid.
See what Meiying did next...
Meiying quickly requested the patient’s signature on the consent form. Meiying showed the completed consent form to the supervisor. The patient checked the filling at the end of the treatment and stated they had changed their mind but hadn’t felt able to communicate this to the student as they seemed to be pre-occupied and in a hurry.
Meiying’s supervisor asked the patient what material they had wanted and to explain what had happened during the consent process. Meiying was immediately apologetic for her actions. She explained she had felt that as she was nearing the end of her fourth year she ought to be getting quicker treating patients. If appointments were running late Meiying felt very stressed and that she was letting patients down. Meiying said she understood how serious it was that the patient now had a filling they were unhappy with. The patient was very upset.
Although this was the first time Meiying had not ensured patient consent was valid the impact on the patient was significant. Meiying’s supervisor explained that because of this a concern about her student fitness to practise would have to be raised. Meiying’s student record was previously excellent. She had also immediately shown insight and acknowledged her responsibility in providing the wrong treatment. Meiying was therefore given a condition and received increased supervision for a period. This was completed satisfactorily and Meiying then continued as normal on the course and did very well in her final assessments. Meiying had to declare the condition on her GDC registration application.
GDC principles
3.3 You must make sure that the patient’s consent remains valid at each stage of investigation or treatment.
3.3.1 Giving and obtaining consent is a process, not a one-off event. It should be part of on-going communication between patients and all members of the dental team involved in their care. You should keep patients informed about the progress of their care.
3.3.2 When carrying out an on-going course of treatment, you must make sure you have specific consent for what you are going to do during that appointment.
Other guidance
Ask your training provider if there is any other guidance or information they would recommend.
Discussion points
- Has a patient you have been treating ever changed their mind about their choice? How did you respond? If this happened again would you do anything differently to ensure patient consent remained valid?
- Have you seen another member of the dental team go ahead with treatment without gaining patient consent? What should you do in this situation as a registrant?
Disclaimer
These fictional case studies are for illustration purposes only and should not be relied on to make clinical decisions. Their aim is to put GDC guidance in context, exploring how some of the principles might work in practice.
The case studies cannot be relied on to be clinically accurate. Nor do the case studies intend to show the "correct" interpretation of GDC guidance, only one (or more) possible interpretation(s).
Principle 4 - Maintain and protect patients' information
Naomi
Naomi is a student dental therapist in her first year of study and wants to ask her fellow students if they have had experience with serious decay in a patient’s teeth due to their dietary habits and how they have dealt with it.
Naomi has a 23 year old patient with badly decayed teeth. Two molars have abscesses. The problem was caused by excessive consumption of sugary carbonated drinks. Naomi is very shocked at the amount of decay and wants some advice and support from fellow students. She posts a radiograph of the affected patient on her social media page ensuring that privacy settings are restricted to fellow students she knows. The radiograph shows the name and date of birth of the patient. The reaction to the amount of fizzy drinks the patient consumes causes a discussion on social media between the students. One of the group shares the story with student friends outside the course and shows them the radiograph to highlight the state of the teeth. One of the friends then messages Naomi to tell her that she has left the patient’s name and date of birth on the radiograph. The patient is unaware that her confidentiality has been broken.
What do you think Naomi should do next?
Select an option:
- Remove the image from her social media account and ask her friends to do the same as this will solve the problem.
- Tell the patient what has happened.
- Speak to her supervisor about what has happened.
See what Naomi did next...
Naomi removed the image from her social media account and asked her friends to do this. However, the ex-partner of the patient had discovered the online discussion about his previous partner. He posted the image on his social media account, making cruel jokes about his previous partner. The patient found out and was very upset and complained to the dental school.
Breaking patient confidentiality is an extremely serious issue. Naomi’s supervisor explained that it doesn’t matter what security settings you have, something you post can be shared outside of a group and so you should always assume that anything you post is public and will remain in the public domain even after being deleted. In this case the implications were very serious. Although Naomi had not intended this to happen and had thought she had the appropriate security settings she had still broken patient confidentiality.
Naomi immediately apologised to the patient. Her supervisor had to call the student fitness to practise of Naomi and the student in the group who shared the post in to question. Naomi and the other student received a short suspension from the course and remedial tuition. Naomi had to declare this on her GDC application form. The sanction was serious because of the impact on the patient and the fact she hadn’t immediately informed her supervisor.
GDC principles
4.2 Protect the confidentiality of patients’ information and only use it for the purpose for which it was given.
4.2.1 Confidentiality is central to the relationship and trust between you and your patients. You must keep patient information confidential. This applies to all the information about patients that you have learnt in your professional role including personal details, medical history, what treatment they are having and how much it costs.
4.2.3 You must not post any information or comments about patients on social networking or blogging sites. If you use professional social media to discuss anonymised cases for the purpose of discussing best practice you must be careful that the patient or patients cannot be identified.
Other guidance
- GDC social media guidance
- External
- NHS guidelines on social media
Discussion points
- How would you feel if someone shared something confidential about you on social media?
- Have you thought about how easy it might be to accidentally let confidential information become public?
- Do you think it would have been okay for Naomi to post the radiograph if there had been no reference on it to identify the patient?
- What do you think the repercussions might have been for the dental school?
- Was Naomi breaking the law?
- Have you ever posted something on social media and then wished you hadn’t?
- How could you avoid this?
Disclaimer
These fictional case studies are for illustration purposes only and should not be relied on to make clinical decisions. Their aim is to put GDC guidance in context, exploring how some of the principles might work in practice.
The case studies cannot be relied on to be clinically accurate. Nor do the case studies intend to show the "correct" interpretation of GDC guidance, only one (or more) possible interpretation(s).
Principle 5 - Have a clear and effective complaints procedure
Abiola
Abiola is a student dental hygienist in the final year of study, cleaning a patient’s teeth on a work placement in a dental practice. After the procedure the patient wants to complain that the use of the scaler was too painful.
Student dental hygienist
During the treatment the patient seemed nervous and winced a couple of times. Abiola paused and checked the patient was happy to continue with the treatment. The patient said the procedure was hurting and asked if she could be gentler. Abiola proceeded and the patient didn’t ask for her to stop. At the end of the treatment the supervisor left the work station to check another student. While the supervisor was absent the patient said that the procedure was very painful and that they would like to complain and feed this information back.
What do you think Abiola should do next?
Select an option:
- Explain to the patient that this procedure can be painful and that she followed the correct guidelines and had stopped to check what was wrong.
- Tell the patient that she would ensure this wouldn’t happen next time because she could administer local anaesthetic and that she was very sorry that her treatment had caused pain.
- Apologise to the patient, and say that she valued feedback. Then explain that there was a complaints process, what it was, and tell the supervisor what happened when they returned to the room. Consider asking for guidance on her technique.
See what Abiola did next...
Abiola was worried that a complaint might affect her chances of passing the final assessments. Abiola explained to the patient that it was quite normal for this cleaning process to be painful and that she had stopped to check with the patient that they were happy to proceed.
The patient said they were unhappy with the treatment and although they were given a chance to explain that they were in pain and that they were happy to proceed once they had received reassurance that she would adjust the technique to take account of this they still found the process painful. The patient felt quite stressed and left before the supervisor returned. Abiola didn’t report the complaint to her supervisor. The patient left a complaint with reception. The receptionist then informed her supervisor at the end of the day.
Abiola’s supervisor raised the issue the next day. Abiola admitted that the patient had wanted to complain but that she felt she had done everything she should during the appointment. Her supervisor explained that the patient has a right to complain and receive a prompt and constructive response including an apology where appropriate.
Feedback is a normal part of professional life and the information can help improve the service provided and your work. Abiola said she recognised this. They discussed the appointment and agreed that Abiola had acted appropriately when she noticed the patient appeared to be in pain. They concluded that in a similar situation it would be beneficial to check the patient was comfortable more regularly. Her supervisor also offered to look at Abiola’s technique to see whether she required some further training and help.
This was the first time this had happened and Abiola responded appropriately once the issue had been raised. The supervisor therefore didn’t raise a concern about her student fitness to practise. However, it was made clear that if it happened again a concern may be raised.
GDC principles
5.1 Make sure that there is an effective complaints procedure readily available for patients to use, and follow that procedure at all times.
5.2 Respect a patient’s right to complain.
5.2.1 You should not react defensively to complaints. You should listen carefully to patients who complain and involve them fully in the complaints process. You should find out what outcome patients want from their complaint.
Other guidance
NHS complaints guidance.
Discussion points
- Has a patient ever complained about your work? How has undertaking this process changed the way you care for your patients? How did you respond?
Disclaimer
These fictional case studies are for illustration purposes only and should not be relied on to make clinical decisions. Their aim is to put GDC guidance in context, exploring how some of the principles might work in practice.
The case studies cannot be relied on to be clinically accurate. Nor do the case studies intend to show the "correct" interpretation of GDC guidance, only one (or more) possible interpretation(s).
Principle 6 - Work with colleagues in a way that is in patients' best interests
Calvin
Calvin is a student dentist in his third year of study. He has just started working in clinic with other members of the dental team.
Calvin has been working in clinic with dental nurses for three months in his third year of study. Sometimes these are student dental nurses and sometime they are qualified and registered dental nurses. Calvin works well with the experienced dental nurses. They are supportive and offer advice, for example, when they notice that he has missed something. He finds this helpful as he is learning the ropes.
His supervisor has noticed that on several occasions when working with student dental nurses that his team working skills are not as good. A couple of student nurses have fed back that he has been dismissive when they have spoken during clinic.
One of the student dental nurses has noticed that Calvin had forgotten to change gloves between patients and discreetly brings this to Calvin’s attention, reminding him about patient safety. Calvin tells her to be quiet and that it is not her place to challenge him. Calvin’s supervisor observes this from a distance and calls Calvin aside to discuss the situation.
What do you think Calvin should do next?
Select an option:
- Explain that the student dental nurse is a trainee with less experience than him. As a dental student he would know more.
- Focus on one of the specific comments relating to patient safety to defend his actions and explain that he was about to change the gloves when it was pointed out.
- Listen to the feedback, reflect on the concept of team working and apologise to the student dental nurse.
See what Calvin did next...
Calvin explained that he hadn’t meant to come across as dismissive when the student dental nurses worked with him. He felt as a dental student he ought to be in the role of team leader and would be expected to have more knowledge. Calvin admitted that he was embarrassed that he had forgotten to change his gloves and had reacted inappropriately to the student dental nurse. The supervisor and Calvin discussed the importance of ensuring colleagues felt valued and how this was important in both gaining trust, working effectively and enabling colleagues to raise concerns if there was a risk to patient safety for example.
Calvin was aware his actions had not met the standard required and was able to analyse why. In future, if he was embarrassed by advice a colleague offered he understood that he had a responsibility to respond appropriately. Calvin apologised to the student dental nurse for his actions and thanked her for her advice. No further action was taken as Calvin had shown insight into his actions.
GDC principles
6.1 Work effectively with your colleagues and contribute to good teamwork.
6.1.4 You must value and respect the contribution of all team members.
1.5 You must treat patients in a hygienic and safe environment.
8.1 Always put patients’ safety first.
8.2 Act promptly if patients or colleagues are at risk and take measures to protect them.
Other guidance
Ask your training provider if there is any other guidance or information they would recommend.
Discussion points
- Which registrant category and member of the dental team are you training for? Have you been treated as you would expect to be? What would you do about it if you felt you weren’t valued and respected?
- How well do you think you contribute to the team? Are there things you could do differently to make the team perform better and/or to make others feel valued as team members?
Disclaimer
These fictional case studies are for illustration purposes only and should not be relied on to make clinical decisions. Their aim is to put GDC guidance in context, exploring how some of the principles might work in practice.
The case studies cannot be relied on to be clinically accurate. Nor do the case studies intend to show the "correct" interpretation of GDC guidance, only one (or more) possible interpretation(s).
Principle 7 - Maintain, develop and work within your professional knowledge and skills
Amrita
Amrita is a student dentist in her fourth year of study. She has a patient who requires a small filling in a molar tooth. She has completed simple and more substantial fillings on a phantom head successfully many times and is keen to put her skills to use on a real patient.
Student dentist Amrita is in the clinic with the patient. She starts drilling the tooth and removing the decay in preparation for the filling. The tooth suddenly crumbles and a large fragment comes away. Amrita is surprised as she feels very confident with her technical skill. However she believes she can still easily complete the treatment.
What do you think Amrita should do next?
Select an option:
- Explain to the patient that the tooth is more fragile than it first appeared so the filling may take longer and reassure them so they don’t become anxious. Then finish the procedure as the patient’s mouth is still numb and her supervisor is busy with another patient in the room.
- Explain to the patient the tooth is more fragile than it first appeared and that she will ask the supervisor to check what should be done next, explaining some possible options.
- Remove the tooth fragment quickly, saying nothing and continue with the more complex filling so as not to distress the patient. They have opted for a white filling so they probably won’t notice.
See what Amrita did next...
Amrita disposed of the tooth fragment quickly without saying anything to the patient and then proceeded to complete the larger filling indicating to the student dental nurse not to mention anything was different. She removed what she thought was the full extent of the decay and filled the tooth, noting what she had observed in the patient record.
The supervisor checked the treatment had been completed. After the treatment, when the supervisor confirmed whether Amrita had completed the patient record they noticed the comments relating to the condition of tooth. The patient had to be recalled and the tooth checked. At the re-inspection it was noted that a crack had appeared in the tooth and there was a deficiency in the filling. This required further intervention in the form of a repair to the filling. Amrita was very relaxed about the impact of her actions, didn’t show insight and failed to recognise her actions didn’t meet the standards required.
This was not the first time Amrita had been overconfident in her capabilities and not sought advice when she needed it. As a result the patient’s tooth had been both put at risk and she had not been honest with the patient. Amrita is continuing to show a pattern during patient treatment of failing to recognise her limitations and failing to seek advice which was having a potentially harming effect on patients. Her student fitness to practise was called into question and she was given conditions on her practice. Amrita was required to stop treating patients and was asked to complete further work on professionalism. She was assessed before she was allowed to treat patients again under increased supervision. She had to declare this on her GDC registration application form.
GDC principles
7.2 You must work within your knowledge, skills, professional competence and abilities.
7.2.1 You must only carry out a task or a type of treatment if you are appropriately trained, competent, confident and indemnified. Training can take many different forms. You must be sure that you have undertaken training which is appropriate for you and equips you with the appropriate knowledge and skills to perform a task safely.
7.2.2 You should only deliver treatment and care if you are confident that you have had the necessary training and are competent to do so. If you are not confident to provide treatment, you must refer the patient to an appropriately trained colleague.
Other guidance
Ask your training provider if there is any other guidance or information they would recommend.
Discussion points
- Have you ever had something unexpected happen during a procedure or treatment when you thought you were at a good standard? How did you respond and on reflection do you think it was the right response?
- Do you ever feel unsure about how much detail regarding a procedure you need to tell a patient? What should you do if this happens?
- What other consequences, apart from the physical damage to their tooth, might patients experience if you undertake work which is beyond your ability?
Disclaimer
These fictional case studies are for illustration purposes only and should not be relied on to make clinical decisions. Their aim is to put GDC guidance in context, exploring how some of the principles might work in practice.
The case studies cannot be relied on to be clinically accurate. Nor do the case studies intend to show the "correct" interpretation of GDC guidance, only one (or more) possible interpretation(s).
Principle 8 - Raise concerns if patients are at risk
Iwan
Iwan is a student dental technician who is worried about raising a concern about the actions of a fellow student.
Student dental technician
On a work placement Iwan observed a fellow student Martin lick his fingers and then use them to adapt a wax baseplate for a record block for a patient. He also saw him blowing over a denture to remove dust that had been generated when grinding the periphery of the appliance which was to be given to a patient. This breached health and safety and infection control requirements.
After observing this Iwan raised the issue with Martin. He didn’t tell the supervisor as the students were friends and he was worried it could affect their work placement. Martin explained why he did this, for example it was more convenient than using the air-line to blow away the debris, but said he recognised it was breaching health and safety and infection control guidelines and would stop. Two weeks later Iwan noticed Martin doing this again.
What do you think Iwan should do next?
Select an option:
- Leave Martin to carry on. After all he had told him about the dangers to his health and the possible risk to the patient so now it was up to him.
- Speak to Martin one last time in the hope that he would change his ways.
- Tell the work place supervisor what Martin had been doing.
See what Iwan and Martin did next...
Iwan
When Iwan told the supervisor what he had observed he was thanked for bringing the matter to the training provider’s attention. Iwan was asked whether it was the first time he had observed this happening and then he admitted that it wasn’t. He explained he felt under pressure not to say anything and that his friend had reassured him that they wouldn’t do it again.
Iwan recognised that there was an issue with not reporting the incident immediately and apologised, independently committing to always reporting a patient safety incident immediately in future. The supervisor reported the incident to the college tutor and an investigation into the incident ensued. Upon conclusion of the investigation Iwan was issued with a warning which was noted on his personal record.
Due to the fact that Iwan demonstrated immediate insight and apologised a student fitness to practise hearing wasn’t required. Iwan was not required to declare this on his GDC application form at the end of the course as it was an isolated warning and no formal student fitness to practise process took place.
Martin
The supervisor met with Martin and notified him that an observation had been made about his practice in the work placement. Martin’s initial response was to ask who had reported this and appeared angry that someone had told on him. Martin also denied doing this. Martin was told that the incident would be reported to his college tutor and then investigated.
The investigation was carried out and another student came forward with the same observation. Martin then admitted that he did frequently lick his fingers to adapt the wax and blew over dentures to remove the debris but tried to minimise the seriousness of it to the investigator. As a result the investigator referred the issues to the student fitness to practise panel. During the hearing Martin apologised for his actions and said he recognised the health issues to himself and the possible risk to patients.
The outcome of the hearing was that Martin’s student fitness to practise was judged to be impaired and he received the following sanction: Martin was warned that his work placement could be suspended if he persisted. Martin was required to complete remedial tuition on patient safety and cross-contamination and infection control followed by increased supervision for six months on his work placement. Martin met the conditions and completed the course. This was noted on his personal record. Martin had to declare this on his application form to register with the GDC.
GDC principles
8.1 Always put patients’ safety first.
8.2 Act promptly if patients or colleagues are at risk and take measures to protect them.
Other guidance
GDC guidance on raising concerns
NHS guidance
Discussion points
- How would you deal with pressure not to tell on a fellow student or friend?
- What might be the possible consequences of not reporting a concern? To you, to the patient, to the person causing the concern.
- How would you feel if something bad happened to the patient and you hadn’t reported your concerns?
- What support might you need after you had raised a concern?
Disclaimer
These fictional case studies are for illustration purposes only and should not be relied on to make clinical decisions. Their aim is to put GDC guidance in context, exploring how some of the principles might work in practice.
The case studies cannot be relied on to be clinically accurate. Nor do the case studies intend to show the "correct" interpretation of GDC guidance, only one (or more) possible interpretation(s).
Principle 9 - Make sure your personal behaviour maintains patients' confidence in you and the dental profession
Chloe
Chloe is a student orthodontic therapist who is celebrating completing assessments for one of the modules on her course with her fellow students.
Student orthodontic therapist Chloe is a conscientious student doing well on her course. She goes out for a meal with her fellow students to celebrate the end of exams in the small market town where they are studying. As the evening progresses one of the students suggests moving on to a pub and the evening extends into a late night and unplanned heavy drinking.
One of the students photographs Chloe holding a bottle of wine and falling over on the pavement outside of the pub they have been drinking at. Chloe’s friend then posts it on social media with the caption asking for a good hangover cure as they are seeing patients in the morning, and describes the patients rudely.
What do you think Chloe should do next?
Select an option:
- Call in sick the next morning explaining she has a virus.
- Go to the clinic in the morning so she doesn’t let down the patients and take paracetamol to reduce the hangover.
- Call in sick with the real reason and apologise.
See what Chloe did next...
Chloe feels terrible in the morning but attends her work placement. Two of the other students are ill and don't turn up. The post is seen by the employer on the work placement who is linked to them on the social media site. Chloe smells strongly of alcohol and the supervisor has to cancel her appointments for patient safety reasons.
Chloe instantly apologises for turning up to the clinic with a hangover. She hadn’t realised that she had been photographed and what had been posted on social media. Her supervisor explained that this could be very serious if patients had seen this. Chloe’s supervisor had contacted the person who had posted it and it had been removed. Her supervisor explained that student dental professionals had to bear in mind that they may be seen differently to students who don’t have responsibility for patients.
As this is the first time this has happened Chloe received a warning which went on her student record. She had shown insight and apologised so no formal student fitness to practise concerns were raised. She had to declare this on her GDC application form.
Chloe’s friend who posted the photograph and comments on the social media site was also questioned about the incident. Her actions had broken the social media policy and her student fitness to practise was called into question. This was not the first time her friend had used social media inappropriately so the student fitness to practise panel issued condition of increased supervision and remedial tuition. She had to declare this on her GDC application form.
GDC principles
9.1 you must ensure that your conduct, both at work and in your personal life, justifies patients trust in you and the public’s trust in the dental profession.
9.1.3 You should not publish anything that could affect patients’ and the public’s confidence in you, or the dental profession, in any public media, unless this is done as part of raising a concern. Public media includes social networking sites, blogs and other social media. In particular, you must not make personal, inaccurate or derogatory comments about patients or colleagues.
Other guidance
Discussion points
- What do you think about what is expected of student dental professionals compared to other students?
- How do you think this might affect how you use social media or behave outside of your course e.g. at the weekend?
- What would you expect if you were a patient?
- What do you think a patient’s reaction would be to seeing this post and reading the comments and what might be the possible consequences?
- Do you think Chloe realised that her drunken behaviour was unprofessional or do you think she was only concerned because it had been photographed and posted on social media?
Other case studies relating to principle 9 can be downloaded below:
David's case study - David is a 29 year old clinical dental technician student and has a part time job in a pub. He has been missing some lectures and rushing his work before his next shift.
Elodie's case study - Elodie is a 23 year old student dental therapist who has been experimenting with drugs at the weekends since she was 19. Recently her drug taking has increased.
Katy's case study - Katy is a nineteen year old student dental nurse who has just started a dental nursing qualification but is worried about a past conviction for shoplifting.
Disclaimer
These fictional case studies are for illustration purposes only and should not be relied on to make clinical decisions. Their aim is to put GDC guidance in context, exploring how some of the principles might work in practice.
The case studies cannot be relied on to be clinically accurate. Nor do the case studies intend to show the "correct" interpretation of GDC guidance, only one (or more) possible interpretation(s).