Adding problem-based learning tutorials to a traditional lecture-based curriculum: a pilot study in a dental school

This article reports on the implementation of a problem-based learning (PBL) tutorial in our advanced program for second year students within an existing curriculum. The program was opened on the last 5 days of the summer vacation and students could volunteer to be part of the group. Students separated themselves into small groups by random sampling. The PBL tutorials were done during the first 3 days for medical problems according to our original scenarios (based on medical cases), and during the last 2 days, students made presentations of their learning outcomes, using information technology (IT) by themselves. Throughout this program, students were expected to engage in self-learning, except for a 1¹/₂-h group session with a tutor. Assessment was done by attendance at a group session and by portfolio analysis. Following the portfolio analysis, students identified the number of learning issues (group A, 26 ± 7 issues; group B, 20 ± 3 issues; group C, 21 ± 7 issues). Research, by questionnaire, revealed that 84% of the students were strongly interested in each scenario and 95% of the students felt familiar with each scenario. The levels of satisfaction with the tutor were different in the three groups. All of the students were comfortable in the discussion room and IT center. These results suggested that PBL tutorials are supported by the scenario, the tutor, and the location of the group session, as well as by self-learning. Moreover, one of the most important factors for a PBL tutorial that the student is ready for the free discussions and has enough time for individual self-learning.     

Application of problem-based learning to clinical dental education

Problem-based learning provides a mechanism for learning in a manner that most closely simulates the future practice environment. PBL was initiated in medical education in the 1960s, and two-thirds of U.S. medical schools use PBL in their programs. The University of Southern California School of Dentistry has moved to the PBL model to give its dental students the knowledge base required to meet accreditation standards and to prepare them to be beginning general practitioners. This article explains how USC uses PBL in its dental curriculum.     

Challenges and relevance of problem-based learning in dental education.

The rôle of PBL as an innovative approach in medical education has been well documented. There has been an emerging trend of incorporating PBL into the dental curriculum. The potential advantages of PBL as a mode of learning encompass the enhancement of an integrated approach in solving dental-treatment-related problems, the development of critical thinking and problem solving skills and the encouragement of independent life-long learning. PBL was introduced into the dental curriculum as a pilot project in the Faculty of Dentistry, National University of Singapore in summer 1996. An example of a case-based study was illustrated and the learning objectives of the study were highlighted. Initial feedback from students indicated a positive attitude to this mode of learning in terms of cognitive, affective and psychomotor skills. Strategies to enhance learning in the PBL environment include time allocation for self-study, availability of resource materials and use of appropriate assessment methods. Problems that remain to be resolved include the choice of appropriate outcome assessment measures to evaluate the effectiveness of PBL as a mode of learning in undergraduate dental education.     

The Malmö model: a problem-based learning curriculum in undergraduate dental education

A new undergraduate dental curriculum was introduced in Malmö in 1990 which is based on problem-based learning (PBL). The principles of PBL are strongly influenced by evidence from cognitive psychology and they form the educational strategy throughout the whole curriculum. Two further essential principles underpin the curriculum: a holistic attitude to patient care, and the promotion of oral health. Basic sciences and clinical dentistry are integrated within a structure based on oral conditions prevalent in the community. Students are encouraged to build their new knowledge, understanding and skills into the context of what they have already learned. This approach is facilitated by the presentation of conceptual models, one of which, The Oral Ecosystem is described in detail. The educational programme also gives students opportunities to learn in the clinical context from an early stage, and we endeavour to promote a scientific attitude from the very beginning of the programme. This paper describes the curriculum at three organisational levels (whole curriculum, single course, individual week).     

Clinical assessment in dental education: a new method

Among the many challenges that face modern dental schools is the development of appropriate assessment systems. The more litigious nature of modern education makes it important that the systems developed are transparent and can withstand the processes of legal challenge. Coupled with this demand for robust assessment is a growing demand from universities and health providers for dental schools to keep rigorous records of student clinical productivity. This brief review outlines a system developed at the School of Oral Health Sciences at the University of Western Australia. The system integrates both qualitative and quantitative assessment and uses criterion-based assessment as its foundation. Detailed analysis and real-time reporting mechanisms using a suite of personally written software tools is now possible. The system provides both students and staff with effective data to enhance the learning process.     

Computer assisted learning: a new paradigm in dental education

Computer assisted simulation is an important teaching modality in the preclinical training of students. In order to maximize the potential of this learning tool, the University of Tennessee's College of Dentistry has successfully incorporated DentSim technology into the restorative curriculum and has recently acquired the technology to make image guided implantology available to students, residents and faculty. This article describes the university's history and experience with simulation as a learning tool. The purpose of this article is to provide information to other educational institutions on the use of virtual reality simulation in the classroom.     

Implementation of problem-based learning in a baccalaureate dental hygiene program

Problem-based learning (PBL) is an instructional method that is gaining popularity in health care education. Rationale for the use of PBL to better prepare health care providers for the future is provided. Implementation of a PBL model into a baccalaureate dental hygiene degree program is described, including examples of activities that may be helpful to others wishing to implement PBL. Preliminary evaluation results indicate positive outcomes in the intended areas of problem solving and critical thinking, team skills, and personal growth.     

Introducing Adelaide dental students to a problem-based learning curriculum.

A course designed to introduce new students to a problem-based learning (PBL) curriculum in dentistry at the University of Adelaide is described. Australian students are admitted to the Adelaide dental course either directly from school (SL) or after one or more years of tertiary education (TT). The admissions process is designed to select academically able students who will flourish in a problem-based environment. Some international students (INT) are also selected through a modified admissions process. A 9-item questionnaire derived from frequently-asked questions from previous years was administered to the new students at the beginning and at the end of the introductory course, and each individual's responses before and after the course were compared. There was an increased number of positive responses (significant at P < 0.05 to 7 of the 9 items) after the course. Although the course appeared to be effective in familiarising new students with a PBL curriculum, many students were still uncertain about two items which commonly provoke anxiety, namely how to decide when to stop researching a topic, and how to balance group and solo learning.     

PBL教学在口腔专业技能教学中的应用效果和思考

国内PBL教学很少用于实践课。本文调查了荷兰内梅亨大学教授在我院口腔专业技能训练中开展PBL教学的效果。绝大部分学生对PBL在实践技能教学中的应用给予了积极评价,认为该授课模式可以激发学习兴趣,提高实践技能,比传统授课方法学到更多的知识。但要适用于所有的学生还需从课程的科学设置方面不断地完善,而学生的基础、能力和个性特点等各方面更应当充分考虑,以达到学生学习收益的最大化。     

Problem-based learning in postgraduate dental education: a qualitative evaluation of students' experience of an orthodontic problem-based postgraduate programme

Introduction:  Problem based learning (PBL) has gained wide acceptance in undergraduate education, but less so in postgraduate education. Qualitative research methodologies can help us gain insight and understanding of the students' experience in undertaking such programmes.
Aim:  To evaluate the experiences of postgraduate students undertaking a PBL based postgraduate programme.
Methods:  Focus groups and semi-structured interviews were used to investigate students' experiences. The qualitative data were coded, the codes were grouped into categories and a coding framework developed. From this a construct is proposed to give insight into students' experiences. The validity of this construct was examined by reviewing the literature.
Results:  Students entered the programme with high expectations, but soon found they had challenges to overcome. They came to realise that they were on a journey, rather than undertaking a sequence of separate individual learning events. PBL led to significant tensions both within the individuals and the group, caused by the conflict between appreciating PBL as a 'good thing' and yet finding that `it just doesn't seem to work'. The fear of failure in a high stakes setting only exacerbated these tensions. The literature review revealed an inconsistent approach to the use of PBL and its evaluation in a postgraduate/continuing medical education setting. However it did provide evidence of similar findings in qualitative studies, supporting the construct developed.
Conclusion:  We have proposed a construct to help in understanding the PBL experience for students undergoing a 'high stakes' orthodontic postgraduate programme with a core of PBL.     

Evaluation of a clinical outcomes assessment tool in a U.S. dental school

Quality assurance (QA) programs in dental schools have a component of their program devoted to treatment outcomes. To this end, our institution has implemented TOUCH (Treatment Outcomes Unacceptable for Clinical Health) seminars and Unusual Occurrence Reports (UORs). The seminars allow a faculty member to present a case to faculty and students with feedback from the audience on how the case was managed. The UORs track clinical incidents outside the range of normal. Participation in both of these QA measures has been less than expected. The goal of the current study was to discover the reasons for participation and lack of participation. A twelve-item survey was completed by seventy-one clinical faculty members and analyzed for trends. Faculty report only 28.3 percent of the unacceptable outcome cases they know about. The two most common reasons given for reporting an unusual occurrence were that it would help the institution reduce similar incidents and it would provide an opportunity to share learning experiences. The most common reason given for not reporting an unusual occurrence was not remembering to do so. Faculty members were most willing to present a TOUCH seminar if guaranteed that no negative repercussions would result. Suggestions for increasing participation in both programs include emphasizing their value, modifying the seminar format, providing more reminders, and reassuring against repercussions.     

Student tutors for problem-based learning in dental hygiene: a study of tutor actions

This case study illuminates contextual factors related to the tutor experience when senior students served as tutors for sophomore students in a problem-based learning (PBL) course in a baccalaureate dental hygiene program. Data were collected using various sources and methods. Tutors and administrators were interviewed, those tutored completed an anonymous questionnaire, the tutorial process and tutor training sessions were observed, and related documents were examined. Data analysis included open and axial coding, creation of tutor profiles, and identification of patterns. Tutor training included experiencing the PBL student role, attending class, and weekly seminar sessions facilitated by a tutor supervisor. Analysis revealed that tutor behaviors could be distinguished by the nature of intended actions (e.g., telling, asking, clarifying, acknowledging), emphasis of comments (process, content, social), and facilitation style (directive, suggestive, empowering). Patterns in tutor behavior and attitudes emerged related to comfort or growth and persistence or lenience. Differences in tutor understanding and perception of their role and the purpose of PBL appeared to influence the role the tutor assumed. Other factors that influenced tutor behavior included tutor intentions, tutor training, and environmental factors (e.g., time). The study, incorporating Fishbein's integrative model, suggests points of influence on tutor behaviors.     

Reflective learning in community-based dental education

Learners gain additional value from community-based education when they are guided through a reflective process. The purpose of this article is to describe how structured reflection assignments and methods are incorporated in the University of North Carolina School of Dentistry's community-based DISC (Dentistry in Service to Communities) program. The following strategies are described as ways to enrich community-based learning experiences for dental students: photographic documentation; written narratives; critical incident reports; and mentored post-experiential small group discussions. Fieldwork and course-related examples are drawn from community-based dental experiences to illustrate how reflective teaching approaches can enhance student learning. A directed process of reflection is suggested as a way to increase the impact of the community learning experience.     

The Internet--approaching a ubiquitous tool for dental education.

The Internet holds promise of addressing some of dentists' and dental students' needs caused by the rapid expansion of knowledge. The Internet is used primarily for communication and for courses, but the quality of Internet courses is uneven. The Internet holds potential in formal dental education for supporting information and instructional databases and as an educational administrative tool. The use of the Internet for educational purposes raises issues such as locating resources on line, ensuring information quality, and incorporation of emerging computer architecture. Some projections are offered for the future: increased instructional quality, replacement of textbooks, creating "courses" out of modules of instructional material, faculty becoming coaches, increased use of trained instructional technologists, intelligent tutoring systems, and the merging of information, instruction, and practice systems. Numerous web sites are given.     

Students' perceptions of a blended learning experience in dental education

Introduction

“Flipped” instructional sequencing is a new instructional method where online instruction precedes the group meeting, allowing for more sophisticated learning through discussion and critical thinking during the in‐person class session; a novel approach studied in this research.

Purpose

The purpose of this study was to document dental students' perceptions of flipped‐based blended learning and to apply a new method of displaying their perceptions based on Likert‐scale data analysis using a network diagramming method known as an item correlation network diagram (ICND). In addition, this article aimed to encourage institutions or course directors to consider self‐regulated learning and social constructivism as a theoretical framework when blended learning is incorporated in dental curricula.

Materials and Methods

Twenty (second year) dental students at a Northeastern Regional Dental School in the United States participated in this study. A Likert scale was administered before and after the learning experience to obtain evidence of their perceptions of its quality and educational merits. Item correlation network diagrams, based on the intercorrelations amongst the responses to the Likert‐scale items, were constructed to display students' changes in perceptions before and after the learning experience.

Results

Students reported positive perceptions of the blended learning, and the ICND analysis of their responses before and after the learning experience provided insights into their social (group‐based) cognition about the learning experience. The ICNDs are considered evidence of social or group‐based cognition, because they are constructed from evidence obtained using intercorrelations of the total group responses to the Likert‐scale items.

Conclusions

The students positively received blended learning in dental education, and the ICND analyses demonstrated marked changes in their social cognition of the learning experience based on the pre‐ and post‐Likert survey data. Self‐regulated learning and social constructivism are encouraged as useful theoretical frameworks for a blended learning approach.     

Teaching periodontal pocket charting to dental students: a comparison of computer assisted learning and traditional tutorials

AIM: The aim of this study was to compare the effectiveness of a computer assisted learning (CAL) programme with that of traditional small group tutorials in teaching theoretical and practical aspects of periodontal pocket charting. METHOD: Sixty-one third year undergraduate dental students were randomized to either receive a tutorial or to work through the CAL programme. Students using the CAL programme completed questionnaires relating to previous computer experience and the ease of use of the programme. All students were assessed immediately after the intervention by means of a confidence log, a practical exercise and a further confidence log. They were assessed again three weeks later by means of a confidence log and a multiple-choice written test. RESULTS: There were very few significant differences between groups for any of the assessments used. However, subjective comments indicated that students occasionally felt disadvantaged if they had not received a tutorial. CONCLUSION: CAL and traditional teaching methods are equally effective in teaching periodontal pocket charting to undergraduate dental students.