Implant dentistry in Australian undergraduate dental curricula: knowledge and competencies for the graduating dentist

AIMS: The aim of this paper is to define the key competencies (knowledge, skills, attitudes and values) in the field of implant dentistry, necessary for graduating general practitioners in Australia. The authors have produced a headline reference guide to outline the necessary educational outcomes which can be targeted by the undergraduate curricula in dental schools of Australian universities. This paper focuses on competencies and aims to clarify curricula 'endpoints' rather than processes. The process towards achieving these outcomes and the instructional methods and strategies might vary among universities. The authors acknowledge that there are different ways to reach the targeted learning outcomes and that there is a diversity of curricular approaches, structures and methodologies among Australian dental schools, which are enriching and desirable educationally. Specific educational strategies also with regards to the teaching of implant dentistry have been addressed in previous work and will not be covered in this paper. This paper will not address extracurricular courses, special degrees or training after graduation.     

Dental education in Queensland: II. Principles of curriculum design.

A modern dental curriculum must produce graduates who are competent to practise in a variety of settings immediately upon graduation; cognisant of community needs and the social milieu in which they serve their patients' health needs; able to anticipate and cope with changes following graduation; committed to self-improvement, willing to change to reflect best clinical practice; and equipped with skills for self-assessment and lifelong learning. This requires the appropriate balance of emphasis on educational content and educational process. This paper outlines the design considerations underlying the new BDSc curriculum at the University of Queensland. This curriculum uses an integrated rather than subject-based approach, with student-centred modes of learning as the principal learning style. Active learning strategies develop critical thinking and clinical problem-solving skills. Learning occurs in the context of a clinical situation (either overt or implied). Year 2 provides the major scientific foundations, and later years build upon this base, particularly through problem-based learning. Senior clinical staff involved in teaching in earlier parts of the course, help provide an overt clinical context to learning activities. The integrated curriculum model provides clinically relevant education in basic sciences and scientifically based education in clinical care. The curriculum has a focus on outcomes and on preparation for general practice. Importantly, it has an open and transparent structure, and each component is linked explicitly with the competencies expected of the new dental graduate.     

Dental students,social policy students and learning disability: do differing attitudes exist?

OBJECTIVES: To examine the attitudes of dental students and social policy students towards learning disabilities in order to identify whether attitudinal differences exist and to suggest recommendations in the dental undergraduate curriculum commensurate with Government legislation in the United Kingdom. DESIGN: A cross-sectional survey of all undergraduate dental students at Queen's University, Belfast and all undergraduate social policy students at University of Ulster. METHOD: A convenience sample of all undergraduate dental and social policy students was obtained. The students completed a questionnaire to assess attitude towards learning disability. The data were analysed using Cronbach's alpha, Student's t-test and analysis of variance (one-way fixed effect model). The level of statistical significance was set at 5%. RESULTS: The response rate was 83% for dental students and 97% for social policy students. Dental students had significantly lower mean scores and hence less favourable attitudes to learning disability compared with social policy students. Female dental students had significantly higher mean scores and hence more favourable attitudes to learning disability compared with male students. CONCLUSIONS: The findings show that dental undergraduates compared with social policy students had less favourable attitudes towards those with learning disability. Dental students should receive training in learning disability and undergraduate programmes should be conceptualised as a spiral curriculum. It is proposed that social policy theory should be introduced into undergraduate dental curricula, that early exposure to learning disability in a community setting should be incorporated into the first undergraduate years and in later undergraduate clinical years students should treat patients with learning disability in order to promote experiential learning and reflective practice.     

A new curriculum framework for clinical prevention and population health, with a review of clinical caries prevention teaching in U.S. and Canadian dental schools

To fulfill the Healthy People 2010 Objective 1.7, "Increase the proportion of . . . health professional training schools whose basic curriculum for health care providers includes the core competencies in health promotion and disease prevention," the Healthy People Curriculum Task Force has developed a curriculum framework for clinical prevention and population health for all the health professions. This framework has four components: 1) evidence base for practice; 2) clinical preventive services, including health promotion; 3) health systems and health policy; and 4) community aspects of practice. Within these four common components are nineteen domains, for which each health profession is identifying its own educational objectives. An inventory of knowledge and skills is being developed. A prerequisite to promoting change in the teaching of dental prevention and population oral health is to better understand the current status. Sixty-six of sixty-eight U.S. and Canadian dental schools provided input on the teaching of one important aspect of this wider topic--dental caries prevention--before a December 2002 Clinical Preventive Dentistry Leadership Conference in Cincinnati, OH. In clinical teaching, 68 percent of dental schools included caries risk assessment and also reevaluated preventive outcomes, but while 65 percent included remineralization procedures, only 38 percent specifically reevaluated this outcome. Faculty members have commonalities in attitudes about the advantages and problems in improving teaching in clinical prevention, yet dental schools act individually in curricular design and implementation. The conference introduced a method of conceptualizing change, so that dental schools might address organizational barriers in clinical curriculum development. Even with the new common curriculum framework, other barriers to improved dental prevention and population oral health exist: these include organizational change in dental schools, dental practices, and dental clinics; reimbursement issues and incentives; and lack of accepted and explicit standards in dental care.     

General dentists and special needs patients: does dental education matter?

Special needs patients are one of the underserved dental patient groups in the United States. This study investigates whether undergraduate dental education about special needs patients affects general dentists' a) professional behavior, b) practice characteristics, and c) attitudes concerning special needs patients. Data were collected from 208 general dentists (178 male/30 female; average age: 49.85 years) who were members of the Michigan Dental Association. The more the respondents agreed that dental education had prepared them well, the more likely they were to treat various types of special needs patients and to set up their practices so they could treat them and the more they liked treating these patients. In conclusion, most general dentists did not think their undergraduate dental education had prepared them well to treat special needs patients. However, the better they reported to have been educated, the more likely they were to treat special needs patients. Given the access to care problems for many special needs patients, it seems crucial to revise dental curricula and provide more didactic and clinical education concerning the treatment of special needs patients.     

The development of a primary dental care outreach course.

The aim of this work was to develop the first north-east based primary dental care outreach (PDCO) course for clinical dental undergraduate students at Newcastle University. The process of course design will be described and involved review of the existing Bachelor of Dental Surgery (BDS) degree course in relation to previously published learning outcomes. Areas were identified where the existing BDS course did not meet fully these outcomes. This was followed by setting the PDCO course aims and objectives, intended learning outcomes, curriculum and structure. The educational strategy and methods of teaching and learning were subsequently developed together with a strategy for overall quality control of the teaching and learning experience. The newly developed curriculum was aligned with appropriate student assessment methods, including summative, formative and ipsative elements.     

Implementing evidence-based practice in undergraduate teaching clinics: a systematic review and recommendations

The objective of this project was to identify an effective methodology of approaching and implementing evidence-based principles in undergraduate teaching clinics to promote evidence-based dentistry in future clinical practice. A systematic review was undertaken to examine evidence-based clinical teaching and faculty continuing education. Research published from 1996 to 2002 was retrieved by searching several databases and the Internet, along with conducting hand searches and reviewing bibliographies maintained by faculty experts. Qualitative checklists for different types of studies were created to evaluate the literature. Relevant studies were selected if they met all four predetermined essential criteria and a minimum of two out of three desirable criteria. Systematic reviews were chosen if they met all five essential criteria. Data from selected articles were extracted, and study quality was assessed. We found that three systematic reviews and nine original research articles were deemed methodologically acceptable. Problem-based learning and evidence-based health care interventions increased student knowledge of medical topics and their ability to search, evaluate, and appraise medical literature. Dental students in a problem-based learning curriculum, emphasizing evidence-based practices, scored higher on the NDB I (National Dentistry Boards, Part I) than students in traditional curricula. While effective modules in implementing theoretical evidence-based principles exist, very few high-quality studies are available that examine these principles in dental undergraduate teaching clinics. No methodologically appropriate studies on the education of faculty in the implementation of evidence-based principles are available. Some studies promote promising theories and methodologies of teaching evidence-based care; based on these theories, a comprehensive model is proposed in this article. Considering the strength of evidence in the reviewed literature, we concluded that an evidence-based approach to clinical care is effective.     

A model of dental public health teaching at the undergraduate level in Peru

There has been a growing interest among dental educators regarding the opportunities offered by community-based dental education as a means to allow dental students to assume their role as health professionals in the real world. Although several dental schools have integrated community-based education into their curricula, most have not engaged their students in the development of competencies to address dental health needs at the community level. The purpose of this article is to discuss the teaching-learning experiences in dental public health at the undergraduate level in the Faculty of Stomatology at the Universidad Peruana Cayetano Heredia (FS-UPCH) in Lima, Peru. The teaching-learning activities in dental public health at the FS-UPCH consist of two well-defined stages: experiences in low-income urban communities and experiences in low-income rural communities. Both stages have been designed to make it possible for students to acquire competency in addressing oral health needs at the community level as well as to enlarge and deepen their knowledge about the social and health situation in Peru. In community-based dental education, students are not only placed in community settings to treat individual patients, but also challenged to consider dental public health issues, including the administrative aspects of dental services.     

Interprofessional learning enhances knowledge of roles but is less able to shift attitudes: a case study from dental education

Introduction: Interprofessional education (IPE) purports to improve team working through improved knowledge of the roles of others, and by engendering mutual respect. This case study aimed to determine the impact of an IPE curriculum on knowledge and attitudes of dentistry and dental technology students undertaking these curricula in the new School of Dentistry and Oral Health at Griffith University. All dental technology students and third‐ and final‐ (fifth) year dentistry students were invited to participate. Method: A mixed‐method approach was used to compare attitudes, perceptions and experiences of students involved in our IPE curricula. Quantitative data were evaluated with the Statistical Package for the Social Sciences (SPSS), and qualitative findings were explored through an Excel^® spreadsheet coding frame tested against Leximancer^TM qualitative software for consistency. Results: Forty‐six of the 131 eligible students participated. Readiness for Interprofessional Learning Scales (RIPLS) and focus groups consistently showed that IPE positively influenced professional identity and improved communication between and amongst all students and assisted them in developing their roles. A prevailing sense of greater importance and a lack of mutual respect between dentistry and dental technology students were, unfortunately, evident. The process was, however, sufficient to enhance teamwork and collaboration when planned learning revolved around explicit patient care in the provision of dental prostheses. Conclusion: Further development of such curricula is needed to maximise IP learning (IPL) opportunities, to shift traditional attitudes and, potentially, to improve the outcomes of patient care. To enable this, academic and clinical leaders need to embrace the ideals of IPE.     

Educating dental students about oral health care access disparities

Dental educators provide learning experiences for dental students that help them develop the belief that universal access to oral health care is a social justice imperative that will compel them to provide care to underserved patients after they graduate. To accomplish these learning outcomes, dental schools first recruit underrepresented minority students and students with previous volunteerism experiences. Dental educators then expose dental students to learning experiences in the classroom and in the community, dental school-based clinics, and community health clinics, to help them to develop the requisite knowledge, values, and competencies for serving underserved populations. The long-term, educational outcomes of these learning experiences have not been assessed to date. Systematic surveys should be conducted of dentists who have had these educational experiences to measure the number who actually care for the underserved in private dental offices, community health "safety net" clinics, and the Indian and Public Health Services.     

The development of a modular gerontology curriculum for dental health practitioners

The modular gerontology curriculum offers dental students a needed introduction to major issues they will confront in their practices with ever-increasing numbers of elderly patients. The modular curriculum helps sensitize students and make them aware that the needs of the elderly must be addressed, if the delivery of dental services in the future is to be effective. Students' roles in geriatric care will become better accepted as they receive exposure to information about the older patient population. By familiarizing them with accurate ideas about the elderly, the curriculum can help students eliminate stereotyped thinking and improve their attitudes towards this patient population. As the population becomes progressively more advanced in age, the demand for dental care by practitioners with specialized training in geriatrics will increase. Through the development of structured curriculum in gerontology, dental practitioners will potentially become better prepared to deal with the unique health care needs of this growing population. The development of modular curriculum packages offers a realistic, concise, and timely approach to a cluttered dental curriculum. The appropriate utilization of these packages can stimulate faculty and students to improve and expand their basic gerontologic knowledge, offering improved clinical application. With proper instruction and motivation, the quality of care provided older patients by dentists will improve.     

Teaching the placement of posterior resin-based composite restorations in Spanish dental schools

Objectives: In an area of esthetic dentistry such as posterior composites, in which new materials and techniques are being devolved continuously, it is important to confirm that dental students have a clear understanding of the basic principles of clinical application of this knowledge. Considering that the preparation of dental graduates in Spain may be of interest to competent dental authorities and employers with whom they can work worldwide, this study investigated the teaching of posterior composite restorations in Spanish dental schools. Study design: In late 2009⁄ early 2010, a questionnaire seeking information on the teaching of posterior composites was emailed to the professor responsible for teaching operative dentistry in each of the fifteen dental schools having complete undergraduate dental degree programs in Spain. Results: The response rate was 100%. Most investigated topics did not show noteworthy differences depending on whether the schools were public or private. Variations were found among Spanish dental schools in both the amount and content of the teaching programs concerning posterior composite restorations. Differences were recorded in the teaching of cavity design, contraindications to composite placement, indications for liners and bases, matrix and wedging techniques, composite and bonding systems, light curing and finishing procedures for composite restorations. More consistency was observed in teaching methods of moisture-control, indirect composites and amalgam bonding. Conclusions: As recommended in previously surveyed countries, efforts must be made to promote harmonization of dental curricula to make it easier for graduates to work elsewhere, and to ensure they meet the needs of their patients on entering independent practice. Key words:Aesthetic dentistry, composite restoration, dental education, teaching program, undergraduate dental student.     

Undergraduate students’ experiences of outreach placements in dental secondary care settings

Introduction: Outreach teaching is delivered as part of the undergraduate curricula of many dental schools. Evaluations of outreach in primary care settings have found learning opportunities beyond those available in the dental school setting, but less is known about secondary care placements. The aim of this evaluation was to assess dental students’ experiences of an undergraduate outreach placement in secondary care. Materials and methods: Questionnaire survey based on a single cohort of final‐year undergraduate dental students at Cardiff University who had completed a 1‐week outreach secondment to a District General Hospital. Results: Fifty‐five of the 57 eligible students completed the questionnaire. Outreach placements in secondary care were experienced to provide positive additional educational benefit and were considered to be worthwhile by many (but not all) students. Clinical opportunities and staff teaching varied by site. Discussion: In the current programme, the variability of student experience during secondments to secondary care means that some students report more benefit than others. However, even apparently negative experiences, such as cancelled operating lists, can contribute to the overall outcome in that they accurately reflect the reality of hospital practice. Conclusion: Careful management of secondary care undergraduate secondments is needed to ensure worthwhile learning experiences.     

Special Needs Dentistry: perception,attitudes and educational experience of Malaysian dental students

A compromised oral health condition amongst patients with special health care needs (SHCN) has been associated with the reluctance and shortage of skills of dental professionals in managing such patients. Lack of training and experience at the undergraduate level are reported barriers to the provision of care for this patient cohort. Undergraduate education therefore, plays an important role in producing professionals with the knowledge, skills and positive attitude in treating patients with SHCN. This study aims to determine the level of knowledge, comfort and attitudes of Malaysian undergraduate dental students towards caring for patients with SHCN, as well as their perception on education in this field. A self‐administered questionnaire was administered in the classroom style to final year undergraduate dental students in Malaysian public dental schools. Most students were aware of Special Needs Dentistry (SND) as a specialty after being informed by academic staff. The majority of the students demonstrated poor knowledge in defining SND and felt uncomfortable providing care for such patients. They perceived their undergraduate training in SND as inadequate with most students agreeing that they should receive didactic and clinical training at undergraduate level. A high percentage of students also expressed interest in pursuing postgraduate education in this area of dentistry despite the lack of educational exposure during undergraduate years. The study supports a need for educational reform to formulate a curriculum that is more patient‐centred, with earlier clinical exposure in various clinical settings for students to treat patients with special health care needs, applying the concept of holistic care in a variable clinical condition.     

Rethinking knowledge and pedagogy in dental education

Dentistry as a profession has often been considered both art and science. Traditional dental education has attempted to address both; however, in many places only the science of dentistry is emphasized. The move toward competency-based curricula in dental education requires an expansion of what constitutes meaningful knowledge in the curriculum and what pedagogies best support that curriculum. The scientific and technical knowledge considered foundational to clinical practice is not sufficient to teach competencies associated with the art of dentistry. Habermas, a social scientist, offers a way of looking beyond technical knowledge to consider two other forms of knowledge: practical and emancipatory. Pedagogy that supports development of practical and emancipatory knowledge includes problem-based learning and case methods, heuristics, reflective practica, journals, storytelling, and performance-based assessment methods. These important teaching strategies are being integrated into various dental curricula including a new competency-based dental curriculum at Marquette University's School of Dentistry. It will be critical for dental educators to continue developing these methods to provide efficient and effective education for future practitioners in both the art and science of dentistry.     

General dentists and pediatric dental patients: the role of dental education

The objective of this study was to investigate whether undergraduate dental education affects general dentists' practice characteristics, attitudes, and professional behavior concerning the treatment of pediatric patients. Data were collected with a self-administered mailed survey from 241 general dentists who were members of the Michigan Dental Association (response rate=48.2 percent). While 40.4 percent of the respondents reported that their dental education had prepared them well to treat child patients, only 33.4 percent indicated that their clinical education had prepared them well. The level of educational preparedness was significantly correlated with a) practice characteristics such as how well the practice was set up to treat children and how knowledgeable and comfortable the staff was concerning providing care for children, b) attitudes concerning the treatment of child patients, and c) professional behavior such as the types of services provided for child patients versus the number of referrals made. The findings strongly suggest that educational experiences concerning the treatment of pediatric dental patients will shape future dental care providers' attitudes and professional behavior. Given the lack of access to dental care for children, it seems crucial to carefully evaluate undergraduate dental curricula to ensure that future dental care providers receive sufficient educational and especially clinical experiences concerning the treatment of child patients.     

Dental hygienists' anti-tobacco role: educational perspectives

Dental hygienists need to assume a proactive health education role concerning tobacco use. To help measure, define, and broaden this role, a study was conducted to assess dental hygienists' current clinical practice behaviors, attitudes, and perceived curriculum adequacy concerning anti-tobacco efforts. The relationships among these variables and respondents' academic degree and year of graduation were analyzed. The study population consisted of a proportionate random sample of 500 dental hygienists in five states and the District of Columbia. A self-administered questionnaire yielded a response rate of 79.4 percent. Based on chi-square analyses of individual items, it was found that, when controlling for degree held, year of graduation was not significantly related to clinical practice behaviors or attitudes, but was significantly related to the majority of curriculum adequacy items. Academic degree, when controlled for year of graduation, was not significantly related to clinical practice behaviors, but was related to one attitude and two curriculum adequacy items. Analysis of variance and Duncan's multiple range test revealed the following significant relationships for aggregate data: year of graduation and degree held appeared to have no relationship to aggregate clinical practice behaviors or attitudes, M.S. degree respondents assigned higher curriculum adequacy ratings than did other subjects, and respondents who graduated prior to 1972 assigned their curricula more negative adequacy ratings than did all other graduates. The most recent graduates rated their curricula the most positively. The study's overall findings suggest that a fairly well-developed role for dental hygienists in anti-tobacco efforts exists. Given the current emphasis on health promotion, prevention, and holism in the provision of oral health care, it is commendable, but not surprising, that dental hygiene programs appear to have made positive modifications over time in tobacco-related content.