Professionalism in Dental Education: Key Points for Success

The environment of the educational setting and the role of the professor are seen as important factors that may not be favorable to the professional growth of aspiring dentists.

Since only evaluating the results of the literacy of professionalism can ensure that the educational institutions are achieving these capabilities in their graduates, many strategies were proposed in the literature to develop a variety of independent and effective tutoring and evaluation of professionalism styles.

This study provides insight into how to address current issues in the tutoring-learning process, ensure professional values, support dental students' roles as future professionals deeply committed to improving oral health, and implement ethical- professional behavior and social responsibility by those engaged in the profession from the start of their dental education.

1.Introduction
Professionalism is a key component of the curriculum of institutions and schools that train and educate healthcare workers, beginning in the early years of education. Regarding the field of dentistry, many associations and institutions place a strong emphasis on the value of properly educating and training aspiring dental professionals, particularly in gaining the necessary skills to develop the fundamental principles of professionalism1,2.

The General Dental Council of England3 described the importance of building an early scheme of dental professional behavior, by considering that professionalism must be the backbone of the whole educational process within the curricula of dental schools, in accordance, it is necessary for dental educational institutions to permit and allow the required educational facilities that would provide necessary specialized knowledge and necessary skills that ensures the implementation of professional behaviour, values, and ethical skills in dental students.

In the United States, the American Dental Education Association (ADEA) and the American Dental Association (ADA) have tailored a specified system that incorporate ethical and professional basic values and advised all dental schools to apply this system4,5.

The mission of universities depends largely on two strategic activities: education and discovery. Their mission thus ensures the preservation and transmission of the scientific and cultural wealth of society alongside the advancement of scientific and theoretical knowledge, through critical thinking and by providing new theories and applied sciences6.

Recently, higher education strategies are modified by many advancements, to provide the best well qualified professionals who can cope with the current challenges resulting from the rapid advancements in science and technology. The concept of a good professional, however, is often associated with an expert, who is a knowledgeable person in a certain subject, rather than focusing on the behaviour of being a morally responsible person in carrying out the job or activity he/she conducts7.

Professionals have an unavoidable moral need to be skilled in science and technology, but this is by no means the only moral commitment they have. Whatever their social projection is and regardless of their occupation, practitioners have obligations that transcend beyond this8.

The goal of this article is to define the concept of professionalism in dentistry in contrast to contemporary notions of higher education and transversal skills, as well as the values associated with professionalism, and to assess the various strategies for fostering professionalism in dentistry that can be implemented through curriculum development, educational environment, and teaching methods

2.Dentistry’s Values and Professionalism
The topic of professionalism, ethics, and values in the dental profession has been discussed by a number of contemporary authors and institutions1-4. They all concur that professionalism is essential to the success of dentists.

The most significant goal of dental educational institutions, according to an author in this issue, “is to ensure that students acquire and consistently demonstrate the attributes of professionalism that give the essential requirements for the creation of a certain person, the dentist, in addition to adding knowledge and developing specialized technical skills9.

What are the benefits and principles of professionalism in dentistry? This question should also be at the forefront of professional practice, particularly in the tutoring-literacy process.

Although there isn’t an unambiguous description of professionalism in relation to careers in the health area, there is agreement that values are a key component of professionalism. Values like generosity, responsibility, excellence, tone- assessment, communication, maturity, respect, trustworthiness, honesty, and integrity are among the many delineations1,4,10,11.

A working group of the American Dental Education Association compiled a list of six professionalism-related values in 2009 (ADEA, 2009):4
1.Capability, which refers to developing and maintaining the high degree of specialized knowledge, specialized technical skill, and professional demeanor required for the delivery of clinical treatment and for efficient operation in the dental education setting.
2.Fairness, exhibiting consistency and impartiality in interactions with others.
3.Integrity, which is the quality of being truthful and exhibiting consistency in one’s beliefs, words, and deeds.
4.Responsibility, which includes taking ownership of one’s actions and abiding by any unique rules that apply to others and are necessary for entering a profession.
5.Respect, which recognizes the value of others.
6.Compassionate approach to people served, operating for the benefit of the patients and the public.

3.Applications of Professionalism In Undergraduate Education
The authors have reemphasized that the values associated with professionalism must be at the centre of the curricular training offered in dental education institutions, not only by well structuring and specifying it in the curriculum and in the graduating profile, but also by carrying out actual and accurate conduct since the beginning of professional training, as it is widely accepted that knowledge, skills, and overall professional attitudes will have better chances of success^12-15.

Professionalism and ethical standards emerge from the initial interactions with academics, authorities, peers, and particularly patients, along with respectable theoretical underpinnings¹⁶. Consequently, from a standpoint of values, a new graduate profile is required, with professionals capable of reorganizing scales in the dentist-case relationship, focusing on the person’s dignity, addressing with claims the ethical conflicts appearing in their professional conduct, and significantly expressing with a critical perspective in bioethics and/or research committees.

4.Educatory Circumstances, Climate And The Professor’s Job
Another crucial factor is the environment fostered in dental school institutions, which, once again, does not promote the professional growth of future dentists¹⁷. In addition to the stress and fatigue reported in many studies on dental scholars around the world, it has been demonstrated that the causes of not behaving professionally are due to the difficulties of the course of studies, where patient care is seen only as a set up to be met, with conditions that must be inflexibly sorted out^18-20.

All of these factors contradict appropriate conditions of integrity for establishing professional attitudes. An important aspect is that these student perspectives involve professors’ important job and role, especially at the final and advanced levels of the dental program of studies, which focus on direct clinical training between professor and dental learners across various patient dental treatment disciplines^21-22.

Students therefore would believe that professors only emphasize and reward achieving the best clinical conduct, being the best student, and finishing the program of studies within the allotted time, without taking into account the student’s own responsibility to patients and maintaining equilibrium of ethical and professional behavioral balance. This perspective may support the idea that values of morality in dental education are declininig^21,23.

5.Professionalism Assessment Staregies
There are numerous papers stating that professional evaluation must always be followed by feedback after a clinical appointment with students. Aside from that, reflection portfolios serve as an assessment tool in which professors can utilize comments or questions to consolidate students’ reflections on a given topic^24-26.

There have been reports in the United States concerning healthcare programs that directly measure professionalism by rating each occurrence using specifically created evaluation methods. The Objective Structured Clinical Examination (OSCE) has also been defined as a method for assessing ethics and professionalism²⁷. Several publications concluded that dental educational institutions should utilize and cultivate a variety of independent and effective styles in both tutoring and professionalism evaluation, because only assessing the results of professionalism literacy can guarantee that the academic institutions are achieving these capabilities in their graduates²⁸.

6.Conclusion
Effective professional performance requires both specialized professional skills and broader professional competencies, demonstrating that the teaching of professional values to students is a major responsibility of educational institutions.

Universities are the most suitable environments to serve as a mentor and a conduit for professionalism and standards, which must be exhibited by students’ attitudes and ethical and professional conduct. The role of universities is to adequately train students for their future roles in society, not just to provide knowledge that would seem to make it possible them to practice a given profession, like dentistry.

The level of stress and pressure that students encounter when delivering clinical care to patients, with a curriculum and many conducts that must be performed to finish a scheduled course, is a major cause of dental education’s shortcomings in terms of professionalism-related values.

From this viewpoint, it’s crucial to bring students to professional reality from the start of their academic careers, specifically through integrated clinical sessions. In this sense, achieving clinical competencies through the provision of patient treatment plans with comprehensive care rather than individual behaviour can be a strategy to considerably alleviate the stress that students experience. Additionally, this will help students develop other merge professionalism attributes such as a sense of responsibility and empathy for patients, to recognize them as people who need assistance in improving their dental health rather than as targets for a program or an aim to be achieved.

However, since clinical sessions frequently don’t allow for complete prior planning, it’s crucial for the clinical professor to be responsive and adaptable in this setting of clinical care. As a result, the professor needs to reflect in a professional way to address the feelings and emotions of students. This is a challenging process that relies on the professor’s ability to be adaptable, serve as a real role model for the students in the tutoring-learning process, make the most of every scenario that arise during the students’ clinical work, and, among other beneficial outcomes, express their opinions in a specific scenario.

According to this viewpoint, clinical professors are strongly advised to receive well-structured training in university teaching strategies in order to arm them with knowledge of various styles and evaluation strategies, to assess not just the technical components of the profession but also the provision of professional values, and offer them with tools that will greatly improve the tutoring-learning process.

Last but not least, the dental profession has an enthusiastic dedication for promoting oral health, treating oral health issues in the general public, and enhancing their quality of life. However, in order to do this, those involved in the profession must act ethically as well as responsibly, so the professionalism values and ethical behavior ought to constitute an ongoing priority and be at the forefront of the dental training programs offered.

7.Conflicts of Interest
The authors have declares that there are no conflict of interest.

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