Learning from Mistakes—Dental Students’ Learning Experiences from Adverse Clinical Events

Abstract

Clinical training in the teaching practice is essential for developing patient-specific skills, yet the transition from preclinical to clinical training presents significant challenges for students. This study aimed to comprehend the challenges and issues faced by students at the onset of clinical training. It retrospectively investigated adverse events presented at the advanced dentistry course by third-year pre-doctoral students from classes 202A, 202B, and 202C during their initial ten months of clinical practice at the teaching institution. In this study, adverse events were defined as any undesirable experiences or incidents associated with a clinical treatment and administrative procedures. A total of 279 adverse events presented were categorized into eight disciplines: Treatment planning (TP), Operative (OP), Periodontics (PER), Endodontics (EN), Oral Surgery (OS), Fixed Prosthodontics (FP), Removable Prosthodontics (RP), and Patient Management (PM). The distribution of events was as follows: TP (11.5%), OP (17.7%), PER (13.1%), EN (6.9%), OS (6.2%), FP (24.2%), RP (5.0%), and PM (15.4%), with FP, OP and PM experiencing the highest rates of adverse events. The distribution pattern within the disciplines was consistent, and no statistical difference was observed. Across these disciplines, a lack of clinical skill competency was identified as a primary cause of adverse events. Other contributing issues included miscommunication, insufficient explanations to patients, a lack of administrative support, case complexity, and a deficit in diagnostic examinations and skills. The frequency of causes varied across the three classes, but no significant differences was noted in OP, FP and OS, in which over 80% of causes were related to clinical skill competency. Adverse events in clinical settings are frequent. Knowing these beforehand can aid students’ performance. Students should prepare thoroughly before clinical practice and understand common causes of errors. Educators should recognize the challenges inexperienced students encounter. Awareness of typical mistakes can enhance success in demanding clinical scenarios.