title: Explanatory models in the interpretations of clinical features of dental patients within a university dental education setting.
abstract: Clinicians may acquire biased perceptions during their dental education that can affect decisions about treatment/management of dental decay. This study established explanatory models used by students to interpret clinical features of patients. It employed a stereotypical dental patient under standardised consultation conditions to identify the interpretation of oral health/disease features in the eyes of student clinicians. The study aimed to establish the perceptions of the patient as a client of the university dental clinic, as seen through the ideological lens of a formal Dental Education system. The discourse during simulated clinical consultations was qualitatively analysed to interpret values and concepts relevant to the assessment of restorative treatment needs and oral health status. Three constructs during the consultation were identified: the Dual Therapeutic Realms, the Choices Underlying Treatment Options, and the High-Risk Triad. Comparing these discourse components, the Patient Factors of the Bader and Shugars model for treatment decisions supported the existence of a core set of themes. It was concluded that certain consultation circumstances influenced the adequacy of diagnostic strategies, mainly by introducing loosely defined but highly specific socio-cultural biases ingrained in the Dental Education concepts and diagnostic/treatment needs systems.
authors.affiliation: Center for Health Research, Kaiser Permanente, Portland, Oregon 97227-1110, USA. gerardo.maupome@kpchr.org
authors.forename: Gerardo
authors.initials: G
authors.lastname: Maupomé
authors.forename: Aubrey
authors.initials: A
authors.lastname: Sheiham
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003657:Decision Making; D003729:Dental Care; D003731:Dental Caries / Q000175:diagnosis / Q000628:therapy*; D003812:Dentist-Patient Relations; D004497:Education, Dental; D004955:Esthetics, Dental; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D017145:Models, Educational; D020380:Needs Assessment; D009909:Oral Health; D009910:Oral Hygiene; D010349:Patient Compliance; D016544:Patient Simulation; D011287:Prejudice; D015203:Reproducibility of Results; D012307:Risk Factors; D012575:Schools, Dental; D012959:Socioeconomic Factors; D013335:Students, Dental; D013637:Tape Recording; D016896:Treatment Outcome