The Ethics of Career-Long Learning
It is good to know how little you know, but it shouldn’t discourage you.
Our knowledge and understanding of the world and the universe around us are exploding. This constant expansion is even more phenomenal in the realms of science and human health. Dentistry shares this growth in that our scientific understanding of dental physiology, microbiology, pathology, devices, and materials continues to increase at a remarkable rate. This proliferation in scientific discoveries of relevance to dentistry relate, to a great extent, to the application of genomic investigations, the use of nanotechnology, and the movement toward nontraditional restorative techniques such as dental implants and colored tooth-filling materials.
Today’s dental students are, hopefully, receiving an education that promotes evidence-based concepts and hones critical thinking skills. At graduation, students should be competent generalists with state-of-the-art knowledge and the ability to practice using contemporary approaches.
However, even the finest educational and training program cannot provide their trainees all the knowledge and skills to sustain them for their entire careers. The relentless growth in human knowledge makes this impossible. This is the juncture where an additional educational process is necessary, namely, continuing education (CE) (called “further education” in the United Kingdom and Ireland).
CE, as discussed in this chapter, refers to the formal or informal manners in which individuals build upon their formal education as they are practicing their careers. Therefore, for a dentist, CE is the education undertaken after professional school and, when applicable, residency training. CE can take many formal forms, including: (1) structured classroom or online courses presented by content experts, (2) “hands-on” courses where clinical skills are taught, (3) individual study programs through special sections in journals or online, (4) participation in dental meetings or “study clubs,” or (5) even by being the instructor of a CE course offered to other professionals.
There is no reason why CE cannot be an informal process involving learning through reading or watching instructional videos. However, most groups who regulate CE will not accept informal individual study as an approved CE program, mainly due to problems in documenting participation.
One might ask, why does the topic of CE for dental professionals appear in an ethics book for dentists? Well, one must take a step back to recall why becoming a well-educated health professional has an ethical basis at all. Typically, the first real patient a dental student encounters and begins to manage comprehensively is initially seen during the second year of study. This is because the professors, and in the end the students’ patients, expect the student doctor to possess a certain degree of fundamental knowledge in the basic biomedical and dental sciences, and have some preclinical preparation before being given the privilege of doing potentially harmful procedures on another human being. Patients do not understand what their student doctor should know and be able to do before doing a procedure. They, instead, place their trust in the school and its agents (the faculty and staff) that they have made sure the student is ready to safely manage patients. The faculty designs the appropriate curriculum, decides on the equipment, instruments and supplies that should be available, and determines the correct staffing of the clinical areas. All that the student needs to do, for the most part, is to follow the path laid out by the faculty. The dental school has a duty to the patients of the school to ensure that each of the faculty-designated parameters creates a situation whereby the risk to any patient of something being done inappropriately is minimized. The burden of fulfilling this duty rests almost entirely on the school. Of course, a student may deviate from what they are being taught by the school to do or use on a patient, which is clearly an ethical violation. (This kind of ethical problem is covered elsewhere in this book.)