Teaching remote consultation

Sir, the BDJ has recently published articles describing the use of remote consultations in dentistry during the COVID-19 pandemic.^1,2,3 I would like to draw attention to considerations for teaching undergraduate students and trainees this new type of communication skill.

While demonstrating their value, remote consultations also have limitations, for example being unable to carry out a full soft tissue examination,² and may increase the risk of missing a serious diagnosis or misdiagnosing. This has also been noted by the medical profession, particularly around telephone consultation, where clinician experience and skill are deemed to reduce risk.⁴

From my experience working in hospital oral surgery and oral medicine services during the pandemic, a multitude of factors inform a risk assessment that influences whether a patient is seen remotely or face-to-face, including: patient complaints/concerns about their oral health, NHS trust policy, patient wishes, type of oral disease/problem (confirmed or suspected), patient's accessibility to a device for a remote consultation, distance a patient would travel to our clinic, prevalence of COVID-19, patient's general health and vulnerability to COVID-19. Furthermore, remote consultation requires a different communication approach and arguably more thorough history taking to triage those that require a face-to-face appointment.

It seems inevitable that remote consultation will become a permanent and useful element of dentistry owing to the potential for improved efficiency and accessibility. With the start of the academic year upon us, as dental hospitals and schools, we will need to consider how to teach this new skill set to our students and trainees. This could involve utilisation of observation, role play and peer review to develop both remote communication skills and competencies in facilitating a joint decision with patients about the most appropriate consultation mode.