Over the last two blog articles, I have explored the important topic of influencing, which is ultimately the responsibility of all of us in dentistry and healthcare. This blog is on the completely different subject of philosophy and how this relates to dentistry. Who better to set the scene than J.K. Rowling who made Edinburgh her home. In Harry Potter and the Philosopher’s Stone, Harry Potter discovered his magical heritage on receiving a letter to Hogwarts School of Witchcraft and Wizardry on his 11th birthday.
There are numerous parallels with our College, with our forefathers dabbling in alchemy just as the philosopher’s stone was believed to be capable of changing base metals into silver or gold. In the book, we learned that students do not simply ‘decide’ to go to Hogwarts. They are selected by the Book of Admittance and Quill of Acceptance, which is kept in a tower at Hogwarts. Our College is not altogether dissimilar with the Fellows Roll being kept under lock and key and of course we have a pen for distinguished Fellows to sign this at Diploma Ceremonies. Curiously, there are many other areas of overlap between our College and the Harry Potter books.
Philosophy comes from the Greek word φιλοσοφία which quite simply means a love of wisdom. There are many famous philosophers such as Socrates, Aristotle, Descartes, but at the end of the day we are all involved in philosophy in our day-to-day work. We systematically try to understand the fundamental and increasingly complex aspects of diagnosing diseases and conditions, planning treatment undertaking the technical aspects of care as well as monitoring outcomes and maintaining good overall patient care and develop our own professionalism at the same time. Healthcare and dentistry are not easy with a continuing array of devices, techniques and methods and above all, a wave of information and new evidence coming at us all the time. These all lead to improved patient comfort, faster procedures and better outcomes. From the development of digital imaging, 3D printing to the use of lasers and minimally invasive procedures, dentistry continues to innovate to improve oral healthcare. There is oft mention of specific “philosophies” of dental care too. Dentistry in RCSEd has come a long way since Francis Brodie Imlach, who became a Fellow in 1856. Imlach dedicated his Edinburgh surgical practice to dentistry and was one of the College’s first dentists. Along with James Young Simpson and other colleagues, he philosophised the value of chloroform in surgical practise, and having extracted the first tooth under general anaesthesia in 1847, Imlach became a leader in the field (and later a College president) having used chloroform for over 300 cases in the subsequent nine months.
It is said that philosophers all possess the following virtues: humility, curiosity, charity, courage and grace. Our College values are inclusivity, integrity innovation, respect and professionalism. We all undertake various professional and personal journeys throughout our lives and as with all Members and Fellows, whilst I aspire to all ten of these virtues and values, I do not always get it right. I rely on my colleagues to help me out when things don’t go to plan. Abiding by the College values and our Code of Practice is of course, not negotiable.
Where does philosophy fit in? Through the Joint Meeting of Dental Faculties (JMDF), our Faculty has been intrinsically involved in the development of the thirteen new UK dental specialty curricula which go live in September 2024. This has primarily been through the pedagogical wisdom of our Specialty Advisory Committee (SAC) representatives but also through other stakeholder groups. I know from my experience as an SAC Chair leading the development of the Orthodontic curriculum that there has been much gnashing of teeth with many viewpoints expressed both within and across the specialties. Since publication of the new curricula, JMDF and COPDEND have been focusing on the detail of assessment through the Dental Curriculum Advisory Group (DCAG) which has representatives from other groups as well. Our Vice-Dean, Will McLaughlin has a wealth of experience in postgraduate dental education and brings significant perspicuity to this group as the RCSEd member. As the name suggests, DCAG’s role is to provide curriculum oversight and the assessment strategy for each specialty will involve a combination of formative and summative assessments.
All of the curricula include common generic professional content relating to professional knowledge and management, leadership and team working, patient safety/quality improvement/governance and personal education/training/research/scholarship. These are heady topics and resonate with the College values. Running through all of the generic professional content is the necessity for participation in professional development, and this requires a combination of reflection and philosophy. Human factors are key to being the best that we can be in our professional and, also our personal lives.
Our sister Faculty, The Faculty of Dental Trainers ably led by Director Sarah Manton has developed the DeNTS program, Dental non-technical skills for dentists (Dental Non-Technical Skills (DeNTS) Masterclass. Increasing patient safety: how to assess the non-technical skills of dentists using DeNTS | RCSEd). The philosophy is to increase patient safety by reducing errors related to human factors such as communication, reflection and situational awareness. The course is analogous to the NOTSS (Non-Technical Skills for Surgeons) course and is designed to demonstrate how good non-technical skills improve both clinical performance and pleural patient management. On the course, participants become both practised in using the new DeNTS taxonomy and furthermore calibrated.
Healthcare has come a long way since ancient times, and being a philosopher is only one aspect of delivering excellence in patient care. Human factors and reflection in all aspects of our professional lives are important. Through the revised specialty dental curricula and the formalised generic professional content, non-technical training is now formally embedded in training the next-generation of specialists and this will flow through all aspects of training in time. I would encourage you to consider attending the DeNTS course, which is remarkably innovative in mapping to so many aspects of generic professionalism. The virtues of humility, curiosity, charity, courage and grace are not learned skills but evolve as we develop in our careers within the Faculty of Dental Surgery and Faculty of Dental Trainers. Our Faculties provide the educational equivalent of the philosopher’s stone. Is there scope for another title, “Harry Potter and the Royal College of Surgeons of Edinburgh”?
I am always keen to hear your views, so please feel free to get in touch by email at dental@rcsed.ac.uk.