The tacit dimension of expertise is given considerable prominence in the literature on clinical education. However, the concept of knowing more than you can tell is one that cannot be used explicitly to support student learning. In this paper, the authors contend that much professional knowledge that has been described as tacit can be surfaced for examination through application of concept mapping techniques. This allows the articulation of expert practice in a way that can be modelled for students. It also provides a new model of expertise that is based on connections between chains of practice (characterized by sequences of observable actions) and the underlying network of understanding from which they are extracted. These connections, often overlooked and automated in daily practice, represent the location of the tacit dimension.Localizing the tacit dimension in this way allows the teacher and student to focus on the connections of tacit knowledge with formal knowledge and with practice in such a way that intuitive actions can be verified and connected to underlying knowledge frameworks. The act of concept mapping also slows reflection on actions that are normally automated and often overlooked. The resulting model includes an additional dimension that is missing from the traditional stage models of expertise. As such, it provides a conceptual framework upon which it would be possible to develop protocols to support the continuing development of clinical teachers through peer observation and/or guided self-reflection.

This paper explores the developing concept of expertise, taking the Dreyfus and Dreyfus staged model as its starting point. It analyses criticism of the Dreyfus model and considers more recent attempts to resolve the tensions implicit within it. The authors go on to suggest ways some of the later modifications can be improved. The traditional notion of intuition is revisited and thereafter a new and novel way of visualising expertise is presented as a dualprocessing relationship between chains of practice and the underlying networks of understanding. These chain and net knowledge structures have been revealed through the analysis of concept maps produced by numerous cohorts of students and teachers. It is argued that a visualisation of the dynamic relationship between the dimensions of expertise provides an emerging theoretical framework for a more general reappraisal of teaching in higher education. This reconsideration of expertise may be the catalyst for dialogue about educational practice within disciplines (between lecturers and between lecturers and students), and between lecturers and educational developers. This dialogue will strengthen disciplinary communities of practice and place the agenda for pedagogic change within the context of the academic disciplines.

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The provision of dental treatment under both local anaesthesia and sedation has an excellent safety record, although medical problems may occur. The high prevalence of cardiac disease in the population, particularly ischaemic heart disease, makes it the most common medical problem encountered in dental practice. Additionally, the increasing survival of children with congenital heart disease makes them a significant proportion of those attending for dental treatment. While most dental practitioners feel confident in performing cardio-pulmonary resuscitation, treating patients with co-existent cardio-vascular disease often causes concern over potential problems during treatment. This article aims to allay many of these fears by describing the commoner cardiac conditions and how they may affect dental treatment. It outlines prophylactic and remediable measures that may be taken to enable safe delivery of dental care.

Aim To compare trends in the volume, socio-demography and academic experience of UK applicants and entrants to medicine and dentistry in the UK with university in general, before and after the major increase in university fees in England in 2012.Methods Descriptive trend analyses of University and College Admissions Services (UCAS) data for focused (preferred subject was medicine or dentistry) and accepted applicants, 2010-14, compared with university in general in relation to socio-demography (age, sex, ethnicity, POLAR 2, region) and academic experience (school type). POLAR2 data provide an indication of the likelihood of young people in the area participating in further or higher education.Results In 2012 the volume of applicants to medicine and dentistry fell by 2.4% and 7.8% respectively, compared with 6.6% for university overall. Medical applications remained buoyant and by 2014 had risen by 10.2% from 2010 to 23,365. While dental applications fell in both 2012 and 2013, they had increased by 15.6% to 3,410 in 2014, above 2010 levels. Females formed the majority of applicants, and admissions, with the proportion gaining admission to dentistry in 2014 reaching an all-time high (64%), exceeding medicine (56%), and university in general (56%). Mature admissions to dentistry were at their highest in 2010 (29%) falling to 21% in 2014, compared with 22-24% in medicine. Black and minority ethnic group admissions to university, although rising (24% in 2014), are still less than for medicine (34%) and dentistry (48%). In 2013, just over half of the students admitted to dentistry were from BME groups (51%) for dentistry. Among UK applicants <19 years, over 60% of applicants, and 70% of accepted applicants, to medicine and dentistry are from the top two POLAR2 quintiles representing areas of high participation in education; however, in 2014 there was a notable increase in the proportion of applications from the lower two quintiles to dentistry (19%) and medicine (20%), with a very modest increase in those gaining admission over 2012 (14% of both; cf 10% and 12% respectively).Discussion The findings suggest that the short-term impact of the 2012 rise in fees had a greater influence on the volume and nature of applicants to dentistry than medicine, and that both programmes are gaining in popularity, despite high fees and reduced places. Dentistry remains particularly attractive to Asians, and females, the latter forming an increasing majority of students. While there is some recovery, social inequalities exist and present a challenge for widening participation in the professions.