Association Between National Board Dental Examination Part II Scores and Comprehensive Examinations at Harvard School of Dental Medicine

Harvard School of Dental Medicine (HSDM) uses a hybrid problem-based approach to teaching in the predoctoral program. The objective structured clinical examination (OSCE) is a formative examination designed to assess the performance of students in the problem-based learning (PBL) curriculum. At HSDM three comprehensive examinations with OSCE components are administered during the third and fourth years of clinical training. The National Board Dental Examination (NBDE) Part II is taken in the final year of the predoctoral program. This study examines the association between the NBDE Part II and the comprehensive exams held at HSDM. Predoctoral students from the HSDM classes of 2005 and 2006 were included in this study. The outcome variable of interest was the scores obtained by students in the NBDE Part II, and the main independent variable of interest was the performance of students in the comprehensive exams (honors, pass, make-up exam to pass). The Mann-Whitney U-test was used to examine the association between the grades obtained in the each of the three comprehensive exams and the NBDE Part II scores. Multivariable linear regression analysis was also used to examine the association between the NBDE Part II scores and the comprehensive exam grades. The effect of potential confounding factors including age, sex, and race/ethnicity was adjusted. The results suggest that students who performed well in the comprehensive exams performed better on the NBDE Part II, even after adjusting for confounding factors. Future studies will examine the long-term impact of PBL on postdoctoral plans and career choices.     

Problem-based learning and research at the Harvard School of Dental Medicine: a ten-year follow-up

Dental students at the Harvard School of Dental Medicine (HSDM) are required to pursue and complete research projects in order to obtain the doctor of dental medicine (D.M.D.) degree. The purpose of this study was to evaluate the effect of curriculum changes on a set of measurable outcomes related to research pursuits. This study was designed as a retrospective analysis of outcomes data from the period 1992-2002. The predictor variable was program format (non-PBL vs. PBL); the outcome variables were the percentage of students listed as authors on an IADR/AADR abstract during their tenure at HSDM and the percentage of students listed as first and/or presenting authors. Univariate statistics were computed for each class, and independent samples t-tests were used to compare the study groups with regard to our outcomes. For the majority of our outcomes, there was no statistically significant difference between the PBL and non-PBL groups, possibly due to sample size limitations. While the implementation of PBL at HSDM has not universally increased student productivity in research, it has not had an adverse effect either. It is possible that students in the PBL curriculum are nurturing other interests, such as community service, while retaining productivity in research.     

Problem-based learning at the Harvard School of Dental Medicine: self-assessment of performance in postdoctoral training

Problem-based learning (PBL) was implemented into the dental curriculum at the Harvard School of Dental Medicine (HSDM) in 1994 with an expectation that this pedagogy would enhance students' critical thinking and communication skills as well as general professional competencies. Previous studies have described several aspects of the outcome of PBL curricula at the predoctoral level. However, there is no information available on the perceptions and performance of PBL graduates during their postdoctoral training in dentistry. The purpose of this study was to evaluate the effect of PBL methodology on the performance of HSDM graduates during their postdoctoral training in comparison with their non-HSDM (traditional) co-residents. Surveys containing traditional knowledge-based criteria, preclinical and clinical criteria, and PBL criteria were sent to HSDM graduates from the classes of 2002 through 2004 who were in postgraduate training programs. The HSDM and traditional graduates were asked to evaluate and compare their performance in selected areas with those of their co-residents from either a PBL curriculum or a traditional curriculum. The directors of each program were also asked to assess HSDM graduates relative to other graduates in the program based on the same aspects. Overall, HSDM graduates rated themselves more highly than non-HSDM graduates on all competencies. No significant difference between HSDM and non-HSDM responses was found in general dental knowledge, specialty specific knowledge, preclinical skills, clinical skills, communication with staff, and patient education, whereas significant differences (p<0.05) were found for communication with patients, critical thinking, independent learning, performance in small group settings, self-assessment, and teamwork. The data obtained from the program directors revealed corresponding results. The HSDM graduates' capacity for independent learning was rated as "excellent" by 65.31 percent of the directors and 80.95 percent of the HSDM graduates themselves. These findings suggest that the performance of HSDM graduates during their postdoctoral training met expectations and were similar to non-HSDM graduates for traditional residency program competencies. However, the PBL training appears to provide HSDM graduates with enhanced abilities in independent learning, communication, and cooperation skills.