Evaluation of teaching performance in U.S. dental schools

This study examines how teaching performance is evaluated in U.S. dental schools. Respondents to the mailed survey were dental school deans. Most schools formally evaluate teaching through student evaluation, yet most deans agreed that evaluation should include input from students and peers. Features that were considered most important in an evaluation program included the provision of a feedback mechanism, the inclusion of faculty input, and a standardization of the evaluation system. The majority of schools provide a program to enhance teaching skills; responsibility for the program varied from the department chairperson to the individual faculty member. More than half of the deans indicated that research productivity can "outweigh" teaching skills in promotion and tenure decisions. The results indicate that dental school deans expect excellence in teaching, but leave doubt as to how faculty members are to gain expertise in this realm of their profession.     

Exposures to blood and body fluids among dental school-based dental health care workers.

A survey of United States dental schools was conducted to determine the annual incidence of reported percutaneous and mucosal exposures to blood and other body fluids among dental school-based dental health care workers (DHCW). A response rate of 51.9 percent provided information on 10,433 DHCW and 1.6 million student clinic and 169,836 school-based faculty practice patient visits. This response represents approximately half of all DHCW and student clinic visits in U.S. dental schools in AY 1996/1997. A total of 652 exposures were reported, of which 629 occurred in student clinics. Dental schools averaged twenty-three reported exposures per year, and the overall annual reported exposure rate in student clinics was 4.0/10,000 patient visits and 1.3/10,000 in faculty practice. Dental students accounted for 62.5 percent of all reported exposures, a rate of 106.3/1000 students per year. The exposure rate for dental students was significantly greater that any other category of DHCW. Expressed in terms of person years, an exposure rate of 0.17 was comparable to that reported for dental schools but considerably less than found in other dental care settings. A second survey directed to individual DHCW drew responses from only 8.3 percent of the 10,433 DHCW. Among these respondents, 31 percent of those acknowledging an exposure reported it. A judgment that the injury was not serious, the time necessary to report an exposure, and a belief that the patient was healthy were the primary reasons for not reporting. The results of this study provide dental schools with benchmarks for comparing their reported exposure experience and assessing programs intended to prevent and manage exposures.     

An assessment of cross-cultural education in U.S. dental schools

The purpose of this study was to assess the status of cross-cultural education in U.S. dental schools and to identify characteristics associated with having a formal cross-cultural curriculum. An eighteen-item survey, which included questions about curricular format, teaching and evaluation methods, time, and course content, was sent to all U.S. dental schools. Comparisons were made using whether or not institutions had formal cross-cultural curricula. Forty-five of fifty-six schools responded. Twenty-nine schools reported having formal cross-cultural curricula in a separate course and/or integrated with other courses with specific goals and objectives. Schools that have formal cross-cultural curricula had higher scores on depth of curricula and spent more time than schools that reported having informal curricula (p=0.03). Competing curricular time and lack of faculty expertise were the most frequently cited impeding factors for inclusion of cross-cultural issues (87.8 percent and 68.3 percent, respectively), while diverse patient population and leadership commitment were the most frequently cited facilitating factors (92.5 percent and 67.5 percent, respectively). There is wide variation among dental schools regarding how they teach these issues and how students are evaluated. Dental schools lack guidance about how to best incorporate this curricular content.     

The current state of predoctoral orthodontic education in the United States

The objective of this study was to assess the current state of predoctoral orthodontic education in the United States. We hypothesized that there are significant differences in the teaching methods, course content, and assessment methods in current predoctoral orthodontic curricula in U.S. dental schools. To test this hypothesis, predoctoral orthodontic directors at fifty-five dental schools were invited to complete an anonymous online survey during the months of June and July 2010. Twenty-nine program directors (53 percent) completed the survey. Our data showed that the mean number of full-time and part-time equivalent faculty members teaching predoctoral orthodontics is 2.12 and 2.5, respectively. Students are presented with orthodontic material as early as the first year in some dental schools; however, the majority of schools present the most orthodontic material in the third year. The number of curriculum hours devoted to teaching orthodontics during the predoctoral years varies greatly between schools, and many programs teach students a variety of orthodontic techniques. Less than half (48.15 percent) of the responding programs require students to treat orthodontic patients. The majority of the responding programs require students to observe residents (65.38 percent), while those requiring students to assist in graduate orthodontics clinic are in the minority (34.62 percent). Two-thirds of the responding programs consider the current time allotted for predoctoral orthodontic clinical education at their institutions to be adequate. Our results suggest that there are, indeed, large variations in teaching methods, curriculum content, and methods of assessment in predoctoral orthodontic programs.     

U.S. and Canadian dental school involvement in extramural programming.

This project was undertaken from July 1999 to August 2000 to identify the status of extramural programming (that is, a program that has undergraduate dental students providing any aspect of dental care to individuals in settings outside the main clinical facility of the school) in North American dental schools. A survey instrument was mailed to all United States and Canadian dental schools concerning student involvement in extramural programming. The response rate was 79.7 percent. Of the schools responding, 3.9 percent did not offer extramural programming. The type of extramural sites, the percentage of schools offering each type of site, and the mean number of weeks students are at each site were as follows: hospital clinics--71 percent, 2.5 weeks; public health clinics--65 percent, 6 weeks; schools and day care centers--49, 1.7 weeks; private dental offices--37 percent, 2 weeks; and "other"--29 percent, 2.5 weeks. The average number of weeks spent at extramural site(s) per class was: freshman 1.9 weeks (SD=4.3); sophomores 2.3 weeks (SD=4.2); juniors 2.6 weeks (SD=1.9); and seniors 5.3 weeks (SD=6.7). Of total student time in extramural programming, 43.3 percent was spent delivering basic clinical services, 24.4 percent comprehensive clinical services, 11.8 percent health education, 11.8 percent preventive dentistry, and 8.7 percent community activities. From the data collected it is apparent that the majority of North American dental schools are providing a variety of extramural experiences for their dental students. It was found that student involvement in extramural programming increases gradually from the freshman to the senior year.     

Characteristics of dental school feeder institutions

A major challenge faced by all dental schools is the need to attract highly qualified student applicants. The purpose of this study was to use 2002-03 AADSAS data to identify and characterize feeder colleges and universities that are the major source of applicants to U.S. dental schools. Feeder schools were defined as any institutions with five or more applicants, and minority-feeder schools as those with two or more minority applicants. Feeder schools were ranked by their total numbers of applicants (Category 1) and by their ratio of applicants to total undergraduate enrollment (Category 2). Feeder institutions were compared using total enrollment, degree status, geographic distribution, religious affiliation, numbers of minority applicants, and college admissions selectivity criteria. The top fifty Category 1 schools had an average enrollment of over 19,000 students and an average of sixty-seven applicants. The top fifty Category 2 schools had an average enrollment of approximately 8,500 students and an average of forty-nine applicants. Less than 1 percent of applicants from the top feeder institutions attended the nation's most competitive schools. California and Utah accounted for 28 percent of the total applicants from feeder institutions, followed by Florida (6.2 percent) and New York (5.7 percent). Seventeen of the top twenty-five Category 2 schools (68 percent) were affiliated with or had student bodies associated with a particular religion, with the Seventh-Day Adventist and Mormon institutions accounting for 544 applicants. The majority of all applicants from feeder institutions attended schools in the Southwest. The majority of black and Hispanic feeder institutions were in Florida, Tennessee, Louisiana, and Puerto Rico. Results suggest that factors such as school size, geographic location, religious affiliation, and admissions selectivity criteria of colleges and universities may have a direct impact on the dental applicant pool.     

A survey of the teaching of conscious sedation in dental schools of the United Kingdom and Ireland

AIM: To assess and compare, for the first time, the quantity and quality of dental undergraduate teaching in conscious sedation in the dental schools of the UK and Ireland. This was achieved using a prospective, questionnaire-based survey. METHODS: Questionnaires were designed to collect information about undergraduate sedation education from teaching staff and final year dental undergraduates at the 16 dental schools in the UK and Ireland. Staff questionnaires were distributed to a nominated sedation teacher at each dental school and sought details of didactic and clinical sedation teaching methods, plus the quantity and perceived quality of sedation teaching. Student questionnaires were distributed to 5th year dental students and enquired about the quantity and quality of clinical sedation teaching received. The survey was undertaken during May-June 1998. RESULTS: Thirteen dental schools returned staff questionnaires (81%). Seven also provided a student response (44%). The proportion of final year students within the 7 schools who returned completed questionnaires was 38%. Sedation teaching was undertaken primarily by oral surgery and paediatric dental departments. Three schools also utilised anaesthetic departments and 2 schools had dedicated dental sedation departments. All but 2 schools provided didactic teaching on sedation (mean: 4.2 lectures, 1.8 seminars). Of the 7 schools which returned staff and student questionnaires, all provided some clinical training using inhalational and intravenous demonstration cases (mean 5.1 and 4.4 cases, per student, respectively). All but one school provided hands-on inhalational sedation experience (mean 2.6 cases per student) but only two schools provided any hands-on intravenous sedation experience. The quantity of hands-on experience was greater at the two dental schools with dedicated dental sedation departments. Across the schools students rated the overall quality of sedation teaching at average or above, but most staff graded the overall quality of teaching at below average. CONCLUSION: Dental undergraduate sedation teaching shows considerable variation across the dental schools surveyed. At most schools students gained little or no hands-on experience in sedation, especially in intravenous techniques. The undergraduate foundation for sedation education must improve if conscious sedation is to become the principal alternative to general anaesthesia in dental practice.     

Infection control in dental school radiology

U.S. and Canadian dental schools were surveyed concerning infection control practices in dental radiology. The majority of respondents reported surface disinfection of intraoral projection operatories (55 percent) and panoramic operatories (61 percent) before or after each patient. The most frequently used surface disinfectant was iodophor. Most schools routinely disinfected the x-ray cone (89 percent) and tubehead (87 percent) of intraoral x-ray machines; however, many did not disinfect the control panel (44 percent) or the exposure button (27 percent). Although 100 percent of respondents reported student use of disposable latex gloves when exposing intraoral radiographs, 27 percent did not use gloves when processing radiographs. Fifty-six percent did not routinely disinfect countertops in the darkroom.     

Issues of academic integrity in U.S. dental schools

Evidence of violations of academic integrity can be identified at all levels of education. A survey on academic integrity was mailed in 1998 to the academic deans of all fifty-five U.S. dental schools, with a response rate of 84 percent. This survey showed that reported incidents of academic dishonesty occur in most dental schools, with the average school dealing with one or two cases a year. The most common incidents of dishonest behavior involved copying or aiding another student during a written examinations; the second most common involved writing an untrue patient record entry or signing a faculty member's name in a patient chart. Respondents indicated the major reason for failure to report academic dishonesty was fear of involvement because of time and procedural hassles and fear of repercussions from students and peers.     

A survey of information technology management at U.S. dental schools

The purpose of this project is to assess how information technology (IT) is being implemented and managed in U.S. dental schools. Recent advances in IT have restructured many of the administrative, curricular, and clinical functions in dental schools. Purchasing hardware and software and hiring personnel to maintain IT present significant financial and administrative commitments for these schools. A nine-question survey was sent to all U.S. dental schools via email with a follow-up postal mailing. Forty-six surveys were returned (83.6 percent response rate). The analysis indicates that dental schools are managing IT in vastly different ways. For example, 71 percent of the schools report a centralized structure, and 61 percent have a line item in the budget to manage IT. On average there are 4.4 full-time equivalents hired to manage IT, with the majority of these people being trained in IT (eight schools reported dually trained IT/dental personnel). The majority of schools report using software to manage their admissions process (70 percent), curriculum analysis (72 percent), and delivery of curriculum content (72 percent), as well as to manage their student clinics (91 percent, business aspect; 87 percent, patients; 65 percent, grading on clinic floor; 76 percent, managing clinical evaluations) and faculty practices (85 percent, business aspect; 65 percent, patients). The use of multimedia (50 percent) and simulation (52 percent) in the preclinical area is mixed. The purchase of laptops (24 percent) and PCs (11 percent) is required in almost a third of all schools participating in this survey. Dental schools in the United States are managing IT in a variety of different ways, using various internally and commercially available tools. The cost to institutions can be large and is usually handled in centralized structures in the school with fixed budgets. The results of this survey can be used to assist schools in the planning and implementation of IT at their institutions.     

A survey of U.S. dental school programs that help students consider academic careers

The faculty shortage in dental education has been reported for many years and is expected to increase. Some dental schools have developed "grow your own" programs that introduce students to academic careers and give them teaching experiences. These programs generally consist of teaching assistant, fellowship, and peer tutoring opportunities. In this study, a nineteen-item survey was sent to fifty-six U.S. dental schools to determine the extent to which such programs were being implemented. Thirty-six out of fifty-six dental schools responded, a response rate of 64 percent. Twenty-five schools or 69 percent of the respondents reported the existence of a formal teaching assistant, fellowship, or peer tutoring program in which students teach in some capacity. The main reasons reported for implementing these programs were to expose students to academia and to address faculty shortages. The respondents reported that positive outcomes for dental student teachers and their students were academic benefits and increased interest in academic life. Among the barriers reported were securing faculty and financial support and problems with scheduling.     

Evaluation of Dental Students as Instructors in Preclinical Prosthodontics and Occlusion Courses

PURPOSE: While facing a shortage of faculty members, dental schools need to be innovative in their educational methodologies. One approach to augment student learning would be to mentor dental students as participating faculty in current courses. A study was undertaken to evaluate dental students as instructors in preclinical prosthodontics and occlusion courses. MATERIALS AND METHODS: In spring term 2003, three senior dental students (4DN) and four full-time faculty were assigned as faculty for each of two preclinical courses: fixed prosthodontics and complete denture prosthodontics. In the summer term 2003, two junior dental students (3DN) and five full-time faculty were assigned to teach in the occlusion preclinical course. Each course had previously been conducted with a total of seven full-time faculty. Three types of outcome assessment were accomplished: (1) evaluation by the 2DN students of full-time faculty and student instructors at the end of the course using a standardized university scale of 1 (poor) to 5 (excellent); (2) a survey of student instructors about their experience; and (3) a course debriefing with selected 2DN students. RESULTS: The overall mean instructor-quality score assigned to the student instructors, 4.5 (SD, 0.7), was slightly higher than that of faculty instructors, 4.2 (SD, 0.9). Student instructors were rated higher than or equal to full-time faculty based on the mean response scores for all ten evaluation questions. The greatest difference between faculty and student ratings was in the category of "respect and concern for the students" in all courses. In addition, information gathered from eight student instructors indicated that the experience was a very positive one overall with an increased interest in an academic career noted. Comments from the 2DN students in the debriefing sessions were positive about having student instructors. CONCLUSIONS: This study demonstrated that from the perspective of second year dental students, senior and junior dental students were accepted as preclinical instructors in prosthodontics and occlusion preclinical courses. Additionally, senior and junior students who participated in student teaching had a positive experience. The use of dental students as preclinical faculty in prosthodontics and occlusion appears to be a viable approach for mentoring students in careers in academics, providing student instructors with higher learning experiences, and supplementing the efforts of full-time faculty.     

Teaching ethics in dental schools: trends, techniques, and targets

The importance of promoting ethical behavior in dental students is reflected in the emphasis on formal ethics teaching within the curricula of most dental schools. Over the last three decades, dental educators have addressed the need for ethics training and examined varied teaching approaches. Today, state-of-the-art ethics education has moved from purely didactic instruction to more interactional teaching methods that promote student introspection and group problem-solving. This paper provides an overview of trends in ethics teaching in dental schools and the current teaching approaches advocated in health science schools. In addition, future needs in dental ethics education are explored including the importance of addressing the unique aspects of the dental education environment.     

Current status of predoctoral geriatric education in U.S. dental schools

The elderly constitute the fastest growing segment of the U.S. population. Dental schools must educate dental students so that they are competent and confident in managing the treatment needs of elderly patients. Programs in geriatric dentistry have been developed in response to the changing oral health needs of growing numbers of older adults. The purpose of this online survey was to identify the current status of predoctoral geriatric dental education in U.S. dental schools. A questionnaire relating to the teaching of geriatric dentistry was posted on the World Wide Web, and fifty-four US. dental schools were invited to complete the form. Data from completed questionnaires were submitted to the investigators via email. Following repeated phone calls and emails to urge school administrators to respond to the electronic questionnaire, a 100 percent response rate was achieved. All schools reported teaching at least some aspects of geriatric dentistry, and 98 percent had curricula that contain required didactic material. Sixty-seven percent of schools reported having a clinical component to geriatric dental teaching. Of these schools, the clinical content was required in 77 percent and elective in the rest. Thirty percent of schools reported a specific geriatric dentistry clinic within the school, and 11 percent had a remote clinical site. Sixty-three percent of schools have a geriatric program director or a chairman of a geriatric section. Over a third of schools indicated that they plan to extend the teaching of geriatric dentistry in the future. Geriatric dental education has continued to expand over the last twenty years and has established itself in the U.S. predoctoral dental curriculum. The format of teaching the subject varies considerably among the dental schools. Although didactic teaching of geriatric dentistry has increased markedly in the last two decades, clinical experience, both intramurally and extramurally, did not keep pace.     

Association membership of full-time faculty in dental schools

Based on the current participation rates in the Association, most full-time faculty who are members of the AADS are White males tenured in the clinical sciences. The American Association of Dental Schools has captured a fair share of the full-time dental school faculty as members, but there is still considerable room for growth. In particular, as the composition of the dental school faculty diversifies, we must be sure that all elements of dental education are represented in the Association. Membership in the ranks of junior faculty is low, and currently the members of ethnic minorities and women are disproportionally represented there. There are 2,381 additional potential members among full-time faculty at U.S. dental schools who represent a large and important force for dental education. The effectiveness of the Association would be enhanced by the inclusion of these full-time faculty along with the thousands of part-time faculty, allied dental educators, and members of postdoctoral dental educational programs. In terms of attendance at the AADS Annual Session, almost all the attenders at the meeting this year were Association members (97 percent). Overall attendance at the Annual Session was quite good with about 60 percent of the full-time faculty Association members attending. Attendance rates among the categories we investigated did vary somewhat but not as much as membership by category. In general, dental school faculty who join the Association attend the Annual Session.     

A survey of local anaesthesia education in European dental schools

Objective: A survey of European dental schools was conducted in 2006 to determine the curricular structure, techniques and materials used in local anaesthesia teaching to dental students. Materials and methods: A questionnaire was designed to collect information about local anaesthesia education. The questionnaires were sent to the Dean of each dental school in Europe and Israel; 49 returned the completed survey, resulting in a response rate of 18.4%. Results: Results from this survey show that dental schools are managing local anaesthesia education in different ways. At most schools, theoretical teaching begins during the first half of the third year (41%), half a year before the practical instruction (43%). In 37% of the dental schools, students use non‐human objects to practice before they inject an anaesthetic in humans. The first injection in humans, usually a fellow student (61%), is mostly supervised by an oral and maxillofacial surgeon (65%). The number of injections under supervision usually depends on the individual capabilities of the student (41%). Ten per cent of the schools need permission of a medical ethics committee for the practical instruction on fellow students. All dental curricula include teaching of mandibular block anaesthesia. The majority also include instruction of infiltration anaesthesia of the upper (98%) and lower (92%) jaws in addition to infra‐orbital block anaesthesia (57%). Although 82% of the schools are satisfied with the current curriculum with regard to local anaesthesia, 43% are planning changes, frequently the introduction of preclinical training models. Conclusion: Local anaesthesia teaching programmes show considerable variation across the surveyed European dental schools.     

The oral health assessment tool--validity and reliability

BACKGROUND: The Oral Health Assessment Tool (OHAT) was a component of the Best Practice Oral Health Model for Australian Residential Care study. The OHAT provided institutional carers with a simple, eight category screening tool to assess residents' oral health, including those with dementia. This analysis presents OHAT reliability and validity results. METHODS: A convenience sample of 21 residential care facilities (RCFs) in urban and rural Victoria, NSW and South Australia used the OHAT at baseline, three-months and six-months to assess intra- and inter-carer reliability and concurrent validity. RESULTS: Four hundred and fifty five residents completed all study phases. Intra-carer reliability for OHAT categories: percent agreement ranged from 74.4 per cent for oral cleanliness, to 93.9 per cent for dental pain; Kappa statistics were in moderate range (0.51-0.60) for lips, saliva, oral cleanliness, and for all other categories in range of 0.61-0.80 (substantial agreement) (p < 0.05). Inter-carer reliability for OHAT categories: percent agreement ranged from 72.6 per cent for oral cleanliness to 92.6 per cent for dental pain; Kappa statistics were in moderate range (0.48-0.60) for lips, tongue, gums, saliva, oral cleanliness, and for all other categories in range of 0.61-0.80 (substantial agreement) (p < 0.05). Intraclass correlation coefficients for OHAT total scores were 0.78 for intra-carer and 0.74 for inter-carer reliability. Validity analyses of the OHAT categories and examination findings showed complete agreement for the lips category, with the natural teeth, dentures, and tongue categories having high significant correlations and percent agreements. The gums category had significant moderate correlation and percent agreement. Non-significant and low correlations and percent agreements were evident for the saliva, oral cleanliness and dental pain categories. CONCLUSION: The Oral Health Assessment Tool was evaluated as being a reliable and valid screening assessment tool for use in residential care facilities, including those with cognitively impaired residents.     

Eye safety practices in U.S. dental school restorative clinics, 2006

This study was conducted to determine how much progress U.S. dental schools have made in providing eye protection during restorative (adult operative and fixed prosthodontic) procedures since a 1979 survey. A seven-question survey was placed at a website, and fifty-five different U.S. dental schools were asked to complete the survey. Thirty-one schools responded (56 percent). Eighty-four percent of schools had safety glasses available for patients, but only 77 percent required usage during restorative procedures. Similarly, while 87 percent of schools required dental students working in restorative clinics to wear safety glasses, just 73 percent enforced the policy. Additionally, 84 percent provided blue light protection on curing lights and required students to wear eye protection while doing lab procedures. Compared to the 1979 survey, considerable progress has been made over the last twenty-seven years in protecting dental school patients and students from ocular injuries. Because one would hope to have 100 percent compliance on this issue, there is room for improvement in promoting patient eye safety and teaching good habits to dental students.