370 | Eur J Dent Educ. 2020;24:370–374. wileyonlinelibrary.com/journal/eje 1 | INTRODUCTION As part of the curriculum renewal initiative in the School of Dentistry at the University of Alberta, we critically reviewed the overarching approaches to clinical education (CE) in dentistry. For this perspective manuscript, we searched the literature on these approaches, includ- ing the PubMed database and the two leading journals in dental ed- ucation research (the Journal of Dental Education and the European Journal of Dental Education) using the following keywords: “ap- proach,” “system,” “model,” “clinical education,” “dental education,” “student-centred,” “patient-centered” and/or “person-centered”. We also checked the references of relevant papers to identify additional papers. We identified 16 papers published between 1999 and 2019 that directly discussed CE approaches/systems/models. Overall, we found that the overarching approaches to clinical education (CE) in dentistry had been already identified, described and compared, 1 but not critically appraised from the perspective of CE as a complex sys- tem within academic dental institutions. The importance given to reviewing this body of literature was twofold. First, CE approaches greatly influence student clinical experiences, patient care and clinic revenues as they provide general guidance on how CE is delivered. Second, current CE approaches and the systems informed by these approaches may have limitations that need to be considered when improving CE. We purposefully se- lected some of the identified papers to address the following ques- tions: what has been documented on approaches to CE?, what are their main limitations?, and what would the characteristics of an al- ternative approach to CE be? The objective of our commentary was to critically discuss traditional, overarching approaches to CE and describe an alternative approach. 2 | TRADITIONAL CE APPROACHES AND SYSTEMS Different terms (eg approach, model, system and framework) have been used interchangeably in the literature to indicate how CE has been conceived and implemented. This highlights the need for conceptual clarity, especially because two interrelated, but distinguishable levels of analysis are often confused, namely the Received: 23 August 2019 | Revised: 20 December 2019 | Accepted: 18 January 2020 DOI: 10.1111/eje.12500 COMMENTARY Thinking ecologically about clinical education in dentistry Arnaldo Perez | Jacqueline L. Green | Sharon M. Compton | Steven Patterson | Anthea Senior © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada Correspondence Arnaldo Perez, School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5-597, 11405 87Ave NW, Edmonton, AB T6G 1C9, Canada. Email: perezgar@ualberta.ca Abstract Traditional approaches to clinical education (CE) in dentistry have primarily focused on the needs and interests of students (student-centred), patients (patient-centred) or individuals receiving care (person-centred). Research has shown that giving prior- ity to the interests of one stakeholder (eg students) may negatively affect the inter- ests of others (eg patients, instructors and administrators). In this commentary, we discuss some limitations of traditional approaches to CE and suggest an eco-centred approach that assumes that the interests of all stakeholders must be considered when planning CE due to the interdependent relationships between stakeholders. A description of this new approach is provided, whilst research and innovation are encouraged to develop an ecologically informed system of CE. KEYWORDS clinical dental education, patient-centred education, pedagogy, person-centred education, student-centred education