Reflective practice tool

Policies, Codes, Guidelines and FAQ

To use the reflective practice tool, you need to download and save it as a Word document (158 KB, DOCX). You can then complete your self-review at a convenient time and use your responses to help plan your continuing professional development (CPD). The tool may take up to an hour to complete. The information below is included in the Reflective practice tool.

When to use the reflective practice tool – some scenarios

Your scope of practice – reflective practice tool will help you reflect on your individual knowledge and skills and how they relate to your current practice.

Here are some example scenarios and how the self-reflective tool can help you feel confident when defining your scope of practice.

Example 1: Tiffany is the only dentist and sole operator at her private dental practice. Tiffany has developed a particular interest in managing more complex endodontic treatments for her patients. Before undertaking more advanced cases, Tiffany uses the scope of practice self-reflective tool to gauge whether she might need to do anything to introduce this area of care into her practice.

When considering the education and training section of the tool, Tiffany wonders whether she has the appropriate clinical skills, given the only training she has done is in her university course and a few online webinars. The competence and experience component of the tool prompts her to reach out to her peers who have more clinical experience in endodontics, one of whom is an endodontist. Her peers have offered to mentor her, invited her to observe them in clinic and have recommended hands-on courses which will help her improve her competency and skill. They are also willing to be referred patient cases that may still be too complex for Tiffany’s level of training and experience.

Example 2: Amir has just graduated as an oral health therapist, his new employer is a private dentist who asks that he complete examinations, diagnoses and treatment plans for his adult patients and insists that this is within the scope of an oral health therapist. Amir has completed a qualification from a university that does not provide adult restorative care within its curriculum and does not feel he has the skills to undertake what his employer has asked him to do.

Amir refers to the self-reflective tool. By completing the competence and experience component of the tool Amir can immediately identify that he does not have education or training on completing examinations, determining diagnoses and developing treatment plans for adult patients requiring restorative care.

Amir reviews the workplace requirements and capacity component of the tool with his employer; they both know that programs to extend scope are no longer approved by the Dental Board of Australia. They decide that Amir may increase his scope of practice by undertaking a continuing professional development program they have developed together, which includes, reading texts and journal articles, watching webinars, practical hands-on courses on adult restorative care, and observation sessions with his experienced employer, before undertaking these tasks on his patients.

Example 3: Catherine has been a registered oral health therapist in New Zealand for seven years, most recently she attended a continuing professional development course which taught her to use both ‘anti-wrinkle’ injections and dermal fillers within her practice. Catherine plans to relocate to Adelaide, Australia next year and, having quickly read the Dental Board of Australia’s Scope of practice registration standard believes herself to be adequately educated, trained, and competent.

Catherine uses the scope of practice self-reflective tool to confirm her scope and when Catherine reaches the Legislation and regulations component of the tool, she is prompted to review the relevant South Australian legislation and regulations. When she reads the Controlled Substances (Poisons) Regulations 2011 (SA) she can see that dermal filler or anti-wrinkle drugs do not fall under the authorised S4 drugs oral health therapists may use in South Australia.

Information from the reflective practice tool

Introduction

Practitioners in all divisions of dental registration must only perform dental treatment for which they have been educated, trained and are competent and:

is within their own scope of practice
falls within the definition of dentistry, and
falls within the scope of their dental practitioner division¹.

These regulatory obligations are explained in the Dental Board of Australia’s (the Board) Scope of practice registration standard and Scope of practice guidelines which apply to all dental practitioners.

The Board expects that as a healthcare professional, you know your scope of practice and do not practise beyond the range of your training, qualifications, experience and competence. This is to ensure the safety of the public, so consumers can have confidence in the dental profession when seeking oral healthcare.

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Why develop a reflective practice tool about scope of practice?

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Continuing professional development (CPD) is how dental practitioners maintain, improve and broaden their knowledge, expertise and competence and develop the personal and professional qualities, required throughout their professional lives.

The Board has developed this tool to help you reflect on your individual knowledge and skills and how they relate to your current practice. It is not a tool to benchmark or audit performance and it will not be used by the Board in disciplinary proceedings.

The tool is not a substitute for the requirements described in the Board’s registration standards and guidelines. As a registered dental practitioner, it is your responsibility to ensure that you comply with the requirements of all the Board’s registration standards and guidelines.

You should read the Board’s registration standards, Code of conduct and guidelines before using this tool. Time taken to complete the tool may be claimed as CPD.

When and how you should use the reflective tool

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The Board recommends using this tool regularly to reflect on your current practice, especially when you are considering:

updating or refreshing your knowledge and skills
planning for your CPD cycle
changes in or to your workplace
introducing new technologies, equipment and/or treatments into your practice.

The tool is a series of questions and statements requiring a response, designed to help you reflect on your scope of practice and set your CPD goals. The level of detail you provide in your responses is up to you; the purpose of the tool is to help you, so the more you consider and reflect, the greater benefit you will gain.

As dental care is best delivered using a team-based approach, this tool can be used to support professional relationships between dental team members and ensure collective commitment to patient safety.

Regular self-review of your current practice and discussions about your scope of practice with your team can help you and your team understand how you should work together to deliver the best care to your patients.

Reflect on your own individual scope of practice by responding to these questions and statements

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Influences on scope of practice – Education and training

Quick links: Approved programs of study and Australian Dental Council – competencies of a newly graduated dentist, dental therapist, dental hygienist, oral health therapist and hygienist

Outline your foundation education and training and then describe your current scope of practice (clinical skills/practice).
Explain what steps you have taken to check that your knowledge, clinical skills and practice are consistent with current scientific evidence.
How might you identify any gaps in your knowledge or training? How would you remediate them?
How do you reflect on your education and training as it relates to your competency across your current practice?

Influences on scope of practice – Competence and experience

How do you explain to a colleague, patient or consumer the range and types of treatments you provide?
How do you engage with others (such as your employer, colleagues, peers and team members) to discuss your competencies?
How do you manage complications which may arise from treatments you deliver?
Explain how any previous adverse outcomes, complaints or near misses inform your reflection on your competencies and any action needed.
Describe how your team discusses and understands each member’s competencies.
How do you develop competency when expanding areas of practice or when you incorporate new technologies and techniques into your practice?
How do you make decisions about limiting your scope of practice in certain areas?

Influences on scope of practice – Registration requirements

Quick links: Registration standards and Polices, codes and guidelines

Do you understand the requirements of the Board’s Scope of practice registration standard and guidelines? Describe how you practise within these requirements.
Describe how your conduct follows the Board’s Code of conduct, including delegation, referral and handover of patient care.
How do you work with other members of dental and multidisciplinary healthcare teams to deliver patient-centred care and a culturally safe approach to oral healthcare?
Describe how you write patient notes and keep accurate patient records that demonstrate fully informed patient care.
How do you meet the requirements for CPD under the Board's Continuing professional development registration standard?
How are you sure that your registration includes all the necessary requirements relevant to your scope of practice, e.g. any conditions or undertakings?

Influences on scope of practice – Legislation and regulations

Quick links: State and territory legislation

What legislative and regulatory requirements, such as state and territory legislation, have you had to consider as relevant to your practice?
Describe how you are meeting the requirements of your state or territory legislation and regulations to possess, administer, prescribe or supply medicines, or perform certain radiographic procedures.

Influences on scope of practice – Clinical need

Quick links: Australian Commission on Safety and Quality in Health Care – National Safety and Quality in Health Care Standards

How do you consider and manage the health, social and cultural factors that are relevant to your patients’ oral healthcare and the treatment you provide?
Describe how you explain the possible risks and expected benefits of a procedure.
How do you obtain consent while meeting a patient's or consumer’s needs and circumstances?
Explain how you manage your patient’s ongoing oral healthcare needs after you refer, delegate or handover for treatment outside your scope of practice.

Influences on scope of practice – Recency of practice

Quick links: Registration standards

What do you do to ensure you are practising enough, across the range of your scope, to maintain competency?
How do you identify which areas of your practice need to be strengthened and refreshed?
Are there any recency gaps in your scope of practice that you are already aware of? Will these gaps require you to refresh your knowledge and skills through education and/or training?

Influences on scope of practice – Professional indemnity

Quick links: Registration standards

How often do you review your professional indemnity insurance to ensure it covers the range of treatments you provide?

Influences on scope of practice – Workplace requirements and capacity

Quick links: Infection control obligations

How do you work with your employer (where relevant) to determine and review your scope of practice in the course of your employment?
How do you ensure you work to your scope of practice in agreement with your employer (where relevant)?
Describe the additional practice policies that your employer requires you to carry out in your practice (where relevant).
How do you know there are adequate materials, equipment, facilities and support to maintain patient safety during and after providing care?

After answering the questions and statements above, consider your responses and how they can help you to set clear CPD goals that support strong learning outcomes.

What to do if you identify gaps in your knowledge and skills

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You must take whatever action is needed to meet your regulatory obligations.

If, after completing the tool, you reflect that your competence (knowledge and skills) in a specific area is below expected standards for practice, you should recognise your own limitations to your scope of practice and take steps to address this.

You may need to refer a patient to another dental or health practitioner with the relevant training and competency to perform the practice or procedure in the first instance. You may also choose to develop your knowledge, expertise and skill through education and training, to gain competence in an area of your scope of practice within your division of registration.

Dental practitioners in all divisions of dentistry wishing to strengthen or broaden their knowledge, expertise and competence may do so by completing CPD, but it cannot be used to obtain registration in another division.

If you decide to complete CPD that broadens your knowledge, expertise and competence (e.g. a CPD course to learn a new technique), you must carefully reflect and assess whether you have done training of sufficient quality and acquired competency and sufficient clinical experience to incorporate the new technique into your clinical practice.

All dental practitioners are expected to comply with the Board’s registration standard and guidelines on CPD. Information on the CPD requirements and guidance on how to choose a CPD activity is available on the Board's website.