SciCombinator

Discover the most talked about and latest scientific content & concepts.

Journal: Journal of dental education

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Professional learning communities (PLCs) are defined as “a group of people sharing and critically interrogating their practice in an ongoing, reflective, collaborative, inclusive, learning-oriented, growth-promoting way.” PLCs have been found to be an effective change management strategy in business and education when confronted by rapid change. The American Dental Education Association’s Commission on Change and Innovation in Dental Education new national program-ADEA CCI 2.0-includes the development of a PLC. By employing an “engage and learn” model PLC centered on continuous quality improvement and systems thinking, dental faculty can identify internal and external barriers to change that could lead to innovative solutions to complex issues. This article argues that a PLC is a viable change management strategy to counteract the effect of multiple external forces impacting dental education and thus to develop future-ready faculty.

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Studies of assessment have shown that three elements-multiple assessments, over time, with multiple evaluators-provide the best strategy for global assessment of student competence in a valid and reliable manner, while experts on competency-based education (CBE) have defined the use of portfolios for assessment as a best practice for CBE. The aim of this article is to describe the five-year experience of one U.S. dental school’s implementation of portfolio assessment of student competence as a programmatic global assessment strategy and to share the lessons learned. From approval by the Curriculum Committee to the first graduating class’s portfolios, the steps and lessons learned along the way are described, in hopes of providing guidance to other schools interested in adopting portfolios for global assessment. This assessment strategy required the collaboration of a broad range of administrators, faculty, and students, as well as a high degree of faculty and student development. Calibration of the summative evaluators resulted in an interrater reliability estimate of 0.81. An important lesson learned was that development of reflective writing was underestimated, resulting in initial failure of 12 (11%) of the portfolios for the Class of 2017. Dental schools interested in adoption of portfolios should expect to invest time in the preparation of faculty and students. However, the result of this investment will be an assessment measure considered a best practice in both the assessment and competency literature.

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Progress testing is an innovative formative assessment practice that has been found successful in many educational programs. In progress testing, one exam is given to students at regular intervals as they progress through a curriculum, allowing them to benchmark their increase in knowledge over time. The aim of this study was to assess the first two years of results of a progress testing system implemented in a Canadian dental school. This was the first time in North America a dental school had introduced progress testing. Each test form contains 200 multiple-choice questions (MCQs) to assess the cognitive knowledge base that a competent dentist should have by the end of the program. All dental students are required to complete the test in three hours. In the first three administrations, three test forms with 86 common items were administered to all DMD students. The total of 383 MCQs spanning nine domains of cognitive knowledge in dentistry were distributed among these three test forms. Each student received a test form different from the previous one in the subsequent two semesters. In the fourth administration, 299 new questions were introduced to create two test forms sharing 101 questions. Each administration occurred at the beginning of a semester. All students received individualized reports comparing their performance with their class median in each of the domains. Aggregated results from each administration were provided to the faculty. Based on analysis of students' responses to the common items in the first two administrations, progression in all domains was observed. Comparing equated results across the four administrations also showed progress. This experience suggests that introducing a progress testing assessment system for competency-based dental education has many merits. Challenges and lessons learned with this assessment are discussed.

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Research on dental students' perceptions of clinical learning environments is needed to identify strengths, weaknesses, and need for interventions to sustain high-quality dental education, but a primary challenge has been the absence of an instrument designed to assess these perceptions. The Dental Clinical Learning Environment Instrument (DECLEI) is a new instrument developed specifically for dental clinical learning environments according to psychometric standards and validated in Europe. The aim of this study was to perform a preliminary validation of DECLEI in a U.S. dental school, thus providing data for subsequent validation in a larger, multi-institution sample. After five experienced faculty members assessed DECLEI’s item relevance and content validity, the instrument was distributed in 2016 to 144 third- and fourth-year dental students at the University of Iowa College of Dentistry & Dental Clinics. All 144 questionnaires were completed (100% response rate). The results were tabulated and submitted to principal component analysis with an orthogonal rotation to assess internal structure of the measure. Internal consistency reliability was assessed using Cronbach’s alpha coefficient and corrected item-total correlations. The results showed that, of the initial 24 items, principal component analysis allowed 18 items grouped in five domains: student-faculty interaction, equipment and patient issues, didactic-clinical components interaction, negative perceptions, and self-assessment. The Cronbach’s alpha coefficients for these five domains ranged from 0.52 to 0.80. These results suggest that DECLEI has the potential for use as a reliable instrument to assess students' perceptions of clinical learning environments at U.S. dental schools, thus supporting the need for a definitive validation analysis in a larger sample.

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The aims of this pilot study were to evaluate the short-term impact of evidence-based dentistry (EBD) workshops on educators' use of clinical evidence in their clinical practice and educational activities and to identify barriers they encountered in implementing evidence in their teaching and clinical practice. Between April 2012 and January 2014, a series of EBD workshops was delivered to 31 dental faculty members and postdoctoral students at three Canadian dental schools. Survey I, assessing participants' perceptions of various aspects of the workshops, was administered immediately following the workshops. Survey II, evaluating the impact of the workshops on participants' EBD implementation, was conducted 10 to 31 months after their completion. Survey I was completed by all 31 participants (100% response rate); their mean scores ranged from 3.94 to 4.65 on a five-point scale. Survey II was completed by 20 participants (64.5% response rate; five postdoctoral students and 15 faculty members), using an online 20-item questionnaire. Of the respondents, 19 (95%) reported implementing EBD in their professional activities at that time, and 14 (70%) stated that the workshops had positively helped with EBD implementation. Eight respondents (40%) reported having experienced barriers to EBD implementation, while 15 (75%) reported that their patients/students welcomed use of EBD. The respondents reported believing that strategies such as increasing EBD education and dissemination and improving quality and accessibility of evidence would facilitate the transition to EBD practice. Reported barriers to EBD implementation included resistance and criticism from colleagues, difficulty in changing current practice model, and lack of time.

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The aims of this study were to develop, implement, and assess a contemporary dental curriculum that would be competitive internationally and take into consideration the specific needs of the community in a newly established all-female dental school in Saudi Arabia: Princess Nourah bint AbdulRahman University College of Dentistry (PNUCD). A six-step approach to curriculum development was used. Problem identification, general needs, and target needs were identified, and goals, objectives, and educational strategies were defined. The new curriculum emphasizes producing competent dentists focused on prevention and geared toward the needs of women and children. Leadership attributes, patient-centered care, and research are emphasized in the curriculum. Contemporary educational methods are used to implement the curriculum. In the assessment part of the study, evaluations of the curriculum by students, faculty, and external stakeholders (part-time instructors, program evaluators, and patients) have been mainly positive. Overall, PNUCD provided the opportunity to develop a curriculum that reflects the explosion of scientific knowledge, based on principles of modern educational theory in a unique cultural environment.

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Harvard School of Dental Medicine, University of Maryland School of Dentistry, and the University of Rwanda (UR) are collaborating to create Rwanda’s first School of Dentistry as part of the Human Resources for Health (HRH) Rwanda initiative that aims to strengthen the health care system of Rwanda. The HRH oral health team developed three management tools to measure progress in systems-strengthening efforts: 1) the road map is an operations plan for the entire dental school and facilitates delivery of the curriculum and management of human and material resources; 2) each HRH U.S. faculty member develops a work plan with targeted deliverables for his or her rotation, which is facilitated with biweekly flash reports that measure progress and keep the faculty member focused on his or her specific deliverables; and 3) the redesigned HRH twinning model, changed from twinning of an HRH faculty member with a single Rwandan faculty member to twinning with multiple Rwandan faculty members based on shared academic interests and goals, has improved efficiency, heightened engagement of the UR dental faculty, and increased the impact of HRH U.S. faculty members. These new tools enable the team to measure its progress toward the collaborative’s goals and understand the successes and challenges in moving toward the planned targets. The tools have been valuable instruments in fostering discussion around priorities and deployment of resources as well as in developing strong relationships, enabling two-way exchange of knowledge, and promoting sustainability.

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Predoctoral dental psychomotor examinations are known to generate high levels of stress among dental students, which may compromise their academic performance. At one U.S. dental school, all 93 first-year dental students were invited to attend a series of three workshop sessions prior to enrollment in their initial operative dentistry course. The workshops were developed to facilitate academic transition from the dental anatomy course to the operative dentistry course; provide early exposure to materials, instruments, and laboratory techniques; support the early development of psychomotor and self-assessment skills; and lessen students' stress and anxiety levels regarding psychomotor examinations. The aim of this study was to assess the impact of the workshops on the students' academic performance and self-reported stress and preparedness. All students who attended the workshop sessions and all who did not were asked to complete a pre-exam survey (immediately preceding the exam) and a post-exam survey (immediately after the exam) on the day of their first operative dentistry psychomotor exam. Of the 93 students, 21 attended one, 34 attended two, and 25 attended three workshop sessions, while 13 students did not attend any. Response rates for the pre- and post-exam surveys were 100% and 98.9%, respectively. Students who attended all three workshop sessions reported being significantly less stressed about taking the exam than the other groups. The mean exam grade of students who attended the workshop sessions was significantly higher than that of students who did not attend the sessions. These findings support the development and implementation of preparatory workshops to improve academic performance and decrease the stress levels of dental students prior to the first operative dentistry psychomotor exam.

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The aim of this study was to assess whether a flipped classroom was an effective model for dental students to learn periodontal diagnosis and treatment planning (DTP). Participants were all third-year students in three academic years (2015-17) at Harvard School of Dental Medicine: two groups that experienced the flipped classroom (Classes of 2017 and 2018), and a control group (Class of 2019) that received the same content in traditional lecture format. All three groups completed a DTP knowledge quiz before and after the educational experience; the flipped classroom groups also completed pre and post surveys of their opinions about flipped classrooms. The flipped classroom group received a 23-minute video and corresponding PowerPoint presentation to view on their own time. In class, these students were divided into groups to diagnosis and treatment plan cases and discuss them with the instructor. Of 71 students in the two flipped classroom groups, 69 pre and post quizzes were returned (response rate 97%), and 61 pre and post surveys were returned (response rate 86%). Of 35 students in the lecture group, 34 completed pre and post quizzes (response rate 97%). The mean pre scores on the knowledge quiz in the flipped classroom groups and the conventional lecture group were 64% and 54%, respectively. After the DTP education, students' quiz scores improved in all three groups, but only the difference in the flipped classroom groups was statistically significant (p<0.01). After the flipped classroom session, 84% of the students agreed or strongly agreed that this methodology was effective for learning periodontal DTP, and 90% agreed or strongly agreed they understood the fundamentals of periodontal DTP-both increases over their pre survey scores. Overall, this flipped classroom model was effective in educating students on periodontal DTP and was well received by the students.

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Administration of safe and effective local anesthesia is a cornerstone of dental practice, but there is some discrepancy in recommendations for maximum doses, with the Council on Dental Therapeutics and American Academy of Pediatric Dentistry’s guidelines differing from the guidelines of manufacturers and contemporary textbooks. The aim of this study was to determine the level of uniformity across U.S. dental schools in teaching maximal safe doses for commonly used local anesthetics. Faculty members primarily responsible for teaching local anesthesia to dental students at all 62 U.S. dental schools that had graduated classes were invited to participate in a survey in March 2017. The survey included questions about maximum doses taught, awareness of the existence of two differing guidelines, and whether one or both guidelines were commonly taught to students. A total of 37 responses were received, for a response rate of 60%. The respondents included oral and maxillofacial surgeons, general dentists, dental anesthesiologists, and periodontists. Of the respondents, 22% reported being unaware of the existence of more than one standard, and there was inconsistency in teaching practices. A majority (73%) reported teaching the higher maximum dose (7 mg/kg) for lidocaine, while a similar but smaller majority (60%) reported teaching the lower dose threshold (4.4 mg/kg) for mepivacaine. This study found no standard recommended maximum dose of lidocaine or mepivacaine being taught in U.S dental schools. Students should be made aware that there is more than one standard, and teaching should emphasize sound medical and pharmacologic principles. There is also a need to ensure that questions on dental licensing examinations are consistent regarding maximum safe doses for local anesthesia.