LAUSR

Independent oral engineers or holistic oral physicians? Undergraduate curricula comprise three parts – a formal curriculum (what is planned), an informal curriculum (what is actually taught) and a hidden curriculum (what is being experienced by students). Behavioural and social sciences (BeSS) comprise such domains as professionalism, management and leadership, aiding understanding of models of health and illness, holistic patient care, communication, reflection and teamwork, and introduce a biopsychosocial approach to dentistry. As such, BeSS is often found within the hidden curriculum of the attitudes and role modelling of faculty, as well as the culture of the educational institution itself. This study, from one UK dental school, explored what appeared to be the negative perception of BeSS amongst dental students. Using structured questions within focus groups comprising students by year group, a number of themes emerged, some of relevance only to the individual school – for instance, that the curriculum was ‘disorganised, overpopulated and lacked cohesion’ and that examination marking was ‘subjective and arbitrary’. However, other themes emerged which, if common in other institutions, may indicate biases against BeSS amongst students and reinforce the view that dentists are simply ‘drill and fill’ technicians, rather than holistic clinicians. Although negatively influenced by what older students were saying about BeSS, year 1 and 2 students were initially receptive to the course ‘teaching us to be, like, decent people’. There was a preference for being taught by dentists – ‘it’s really hard to relate to a psychologist, because they don’t know’ – and that as dentistry is a clinical occupation, these competencies were best taught and modelled by those with direct experience of the profession. As students passed into the later, more clinically based years, the relevance of the course was also questioned, as they ‘would only have 10 minutes with each patient in practice, there would be insufficient time to apply what had been taught’. The authors conclude that in a society with changing dental needs, with less demand for drill and fill and increasing concern for health promotion, a lack of awareness of the influence of personal, social, political, economic and environmental factors on health will leave dentists without an adequate knowledge base to provide holistic oral care. The important role of clinical teachers to be aware of, and to acknowledge the relevance of and complementary nature of BeSS, is stressed. The hidden nature of much of what is understood of BeSS within dental school curricula and the potential biases it produces, should be addressed by all dental schools.