Message Boards
Today's Active Topics Today's Active Cases Browse Forum Categories My Recent Activity My Messages Private Groups My Marked Threads My Subscriptions
Today's Active Images Today's Active Polls Most Active Topics Global Townie Map Advanced Message Board Search Message Board Terms of Use

Employee Training by Andrea Cook

Start Discussion More by this author (5)

“The most valuable asset in an orthodontic practice is the people. One of the most critical issues facing orthodontists today is how to hire, train and retain quality people to achieve and maintain excellence.”— Dr. Steven Seltzer

This statement was published more than 10 years ago. The struggle of how to accomplish this continues in today’s busy orthodontic practice. I was recently in an orthodontic office to implement their new sterilization system. They had a new team member there on her first day with the office. She was watching with eyes wide open as we went through the new system and equipment. I had a minute to ask her how she was doing and almost with tears in her eyes she said, “I am so lost.” When we got a break I asked the clinical coordinator what the training protocol was for the new team members. She replied “Well, it is pretty much sink or swim here. We don’t have time to train.” Sadly, this is the case with many busy orthodontic offices. Training systems such as this have a significantly lower success rate than offices that provide good information, proper training and clear expectations for new employees. Many great team members are lost without a structured training system and a trainer.

The employee base of today is changing. People are much more transient than they have been in the past. It is estimated that today’s students will have 10 to 14 jobs before their 38th birthday! These numbers indicate our offices will be investing more time and energy into training than in previous years. Having a designated trainer and a good training system will make this process much more successful.

Many offices struggle with the “we are always training” cycle that they can’t seem to break. I have found offices that suffer with this vicious cycle have a poor new employee training system or no system at all. Without proper care and feeding even the best new employee will fail if not given information, tools, training and set expectations needed to excel.

Not every new hire can be an all-star employee and we will have failures. There are two types of failures when it comes to training new team members. There are system-based failures and employee-based failures.
    System-based failures include:

  • Lack of a training schedule
  • The trainer is not well trained
  • Lack of written information
  • No clear job description
  • No guidelines and expectations established Employee-based failures include:
  • Tardiness
  • Lack of accountability
  • Failure to meet expectations

If an office loses a new team member based on a system failure, this should be a great concern to the office. The system must be improved in order to stop the cycle of perpetual training and increase the development and retention of great team members.

When a new team member is hired, he or she will move through four basic stages as the member learns the new skills. Each stage presents its own challenges. With great training, patience and care, we can help a person move through them smoothly and develop into a great team member.

    There are four basic steps in the ladder of training:
  1. 1. Unconscious Incompetence
    You don’t know that you don’t know. This new team member does not understand or know all that he or she doesn’t know. The new member must recognize his or her own incompetence, and the value of the new skill, before moving on to the next stage.

  2. 2. Conscious Incompetence
    You know that you don’t know. Though the trainee might not understand or know how to do something, he or she recognizes the fact that he or she doesn’t know it. This can be a pivotal point for a trainee. There can be a level of frustration during this stage. The trainee might feel like he or she will never “get it” and give up if not given the support needed. It is critical to celebrate successes no matter how small in order to build confidence.

  3. 3. Conscious Competence
    You know that you know. This trainee understands or knows how to do something. However, demonstrating the skill or knowledge requires concentration. He or she can accomplish the procedure, but it takes heavy concentration. The time it takes to complete appointments might be longer than the schedule allows.

  4. 4. Unconscious Competence
    You don’t know that you know. It just seems easy. I finally got it! This is your new orthodontic clinician! He or she has had so much practice with a skill that it has become second nature and can be performed easily. As a result, the team member can complete procedures with accuracy and within the scheduled time.

The length of time an individual spends in any of these four stages depends on the strength of the trainer and the training system in your office.

So, let’s set our new team members up to climb the ladder quickly and most efficiently by giving them the tools, training and set expectations they need to become a valuable asset to your office.

If we expect team members to perform, we must make sure we let them know how to perform, as well as provide them with all the tools and training they need to perform those skills. All newly hired team members should receive a packet with office information included. They should receive an office manual, a clear job description, their training schedule and any other information your office provides. Make sure they get introduced to all the other employees and know who their trainer or “go to” person is. I have been in an office during the morning huddle when a new team member has started. After the huddle I heard some team members asking “who was that in the morning meeting?” The answer was, “that is your new team member.” How do you think she felt about joining that team?

Before we can start training our new team members we must determine what we are training them for. From brackets and adhesives to sterilization protocols, orthodontic clinical procedures are different in almost every office. Even when hiring a clinical assistant with 20 years of orthodontic experience, it is critical to train her on how orthodontic patient care is delivered in your office. This is not limited to the clinical area. Clear definition must be outlined for every position in your office from scheduling coordinator, treatment coordinator, records technician, lab technician, etc.

This definition should come in the form of a clear and outlined job description. Most often a clinical assistant is hired with that blanket job description “clinical assistant,” without any definition of what that means for your office. A clinical job description should include the clinical duties, infection control duties, lab duties and all miscellaneous procedures that he or she is expected to perform. Without expectations, how can you expect them to perform well and fulfill their role in your office?

Now that we have the job description clearly defined for the new member, we must give him or her all the information needed to fulfill this role. The first portion of that would be all basic orthodontic information including tooth numbering, names of instruments, a complete list of dental and orthodontic terminology, etc. I recommend this basic information be given to all team members when they join your team. This will help your scheduling coordinators triage the emergency call much better. This will also help your treatment coordinators explain treatment and appliances to new patients.

There should also be information that is specific to your office such as: what types of brackets you use, what “taking records” means to your office, what adhesives you use and what appliances you use with your patients. Offices are quick to assume that an experienced orthodontic assistant can immediately start running a column. So often this sets a trainee up for failure. For example, her bond failure rate may be too high simply because she was never taught how to bond in your office and with your products. This is a system failure and protocols must be in place to help her be successful from the start.

A new team member will also need a training outline. I hear all the time, “well, she has been here a year and still isn’t fully trained.” This failure is most often due to the training system, not the person. Clear expectations and time frames should be set up to help him or her achieve goals. Starting off with short-term goals and celebrating successes will keep him or her motivated during the training process. I recommend having a list for the trainee and the trainer to check off as goals are accomplished. There should be a time frame for 30-, 60- and 90-day goals with accomplishments to check off along the way.

Hands-on training is key to making a new clinicians’ training move quickly. Having the trainer sit with a trainee during a procedure that he or she is not comfortable with makes both parties (trainee and the patient) more confident. I remember the first time I put in an archwire on a patient. I got the patient all tied in and was so proud of my success. That is, until my trainer came over and said “next time, don’t put the archwire in the headgear tube.” I was very deflated by that comment. If I had a trainer that stayed with me and gave me encouragement throughout the procedure, the result would have been much different.

I have worked with many offices who tell me they have a high turnover rate. They’ll say they have a hard time finding good people who want to work. Many times good people are hired and not provided with good training so the cycle continues. Albert Einstein once said, “Insanity is doing the same thing over and over again and expecting different results.” Continuing to hire new team members without a good training system might fall into this insanity definition. The first steps in developing great new employees are:
  • Develop a complete office manual
  • Develop clear job descriptions for every position in your office
  • Set expectations and time frames for your new team members
  • Have a trained trainer – not everyone is meant to train
  • Implement a training system – not just “sink or swim”

We have implemented a great training system into the office above that previously used the “sink or swim” training method. They have successfully trained two new team members. The office, the new team members and their patients are all benefiting from this change. Making these changes in your office might stop the perpetual training cycle and keep you from falling into the definition of insanity!
Author’s Bio
Andrea Cook bases training systems on practical knowledge gained through 20 years chairside experience. Andrea works as a clinical consultant and trainer for premier orthodontic offices across the country. Since effectively training clinical team members is a critical portion to the advancement of clinical productivity and profitability, Andrea works with teams to increase efficiency, improve communication and guides the office to a new level of excellence. For more information, contact Andrea Cook at 253-332-3376 or andrea@andreacookconsulting.com. You can also visit her Web site at www.andreacookconsulting.com.
Orthotown Magazine
October 2025
Orthotown Magazine October 2025 Read Current Issue Read Archived Issues
Sponsors
Townie® Poll
When did you last increase your fees?
  
Site Menu
Message Boards Magazine Continuing Education Podcasts Blogs Classifieds News Events Townie® Poll Ebooks Townie Choice Awards
Company Info
Contact Us Advertise With Us Howard Farran DDS, MBA Policies and Agreements
Site Help
Sally Gross, Member Services Specialist
Phone: +1-480-445-9710
Email: sally@farranmedia.com
©2025 Orthotown, a division of Farran Media • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450