Table 1.

iCARE from the dental preceptor’s and the dental student’s perspectives

From the Dental Preceptor’s Perspective, with Examples	iCARE actions	From the Dental Student’s Perspective, with Examples
Inquire about the patient’s dental history and current condition and about the student’s tentative diagnostic conclusion and possible treatment plans.	i	Identify key facts in the patient’s dental history and current condition, and initiate a discussion of a tentative diagnostic conclusion and possible treatment plans.
What is this patient’s medical and dental history? What did your examination reveal? What is your diagnosis? What is your treatment plan?		My patient’s chief complaint is pain when drinking cold fluids. After reviewing the medical and dental history and completing an intraoral exam, I think the pain is resulting from gingival recession and exposed dentin in the lower-left quadrant.
Cultivate the student’s use of scientific evidence to support the tentative diagnostic conclusion and treatment plan.	C	Contribute evidence to support the tentative diagnostic conclusion and treatment plan.
What patient data support your diagnosis? What scientific evidence supports your diagnosis and treatment plan? Why this treatment plan? What evidence-based reasons do you have for this diagnosis and plan? What are alternative diagnoses and treatment plans that have been suggested in the literature?		I narrowed the list of potential diagnoses and targeted dentin exposure because the radiographic and dental exams were within normal limits. I also recall literature we read in class about the hydrodynamic theory of dentin pain.
Advise the student on general oral health principles relevant to this and other cases.	A	Apply relevant oral health principles to the current case and to other cases.
Generally, when a patient presents with abfractions in posterior teeth, occlusion is the cause of the lesions. I recommend checking the occlusion for interferences along with an analysis of any clenching or bruxing habits.		I’m learning about those principles in our lectures. I’m working on where this information can also apply. I haven’t thought of those options. I have another patient with these symptoms and will conduct these tests to determine if the etiology is the same.
Reinforce what the student has done well and suggest what could be improved.	R	Reflect on what was done well and what could be improved. Integrate principles of evidence-based decision making.
Your analysis of the patient data and integration of findings from the literature were effective. You explained your treatment plans well; you clearly have a handle on alternatives for treatment and criteria for choosing one over another. There is another set of tests and possible diagnoses you might consider in similar situations.		I read a few articles before this appointment that were very helpful in developing the treatment options. I should have thought more broadly about options for materials, since there is a recently published meta- analysis of restorative materials that describe their prognosis in conditions similar to what my patient presents. I was overly influenced by comments from my patient and I should have focused on a recently published systematic review that compared the prognosis of the treatment we are considering to alternative treatment options.
Empower the student to evaluate the current diagnosis and treatment plan by considering scientific evidence, and modify if necessary. Ask the student to develop a timeline for next actions.	E	Execute and, if necessary, modify the treatment plan; and educate the patient.
Would you change anything in your initial treatment plan? Why or why not? What is the next action?		I still think my diagnosis and treatment plan are appropriate based on our discussion and articles I read, but I need to rethink the options for restorative materials and consider preferences indicated by my patient. I will complete the procedures we have discussed and will consult with you before making the impression.