Dental Student Academic Integrity in U.S. Dental Schools: Current Status and Recommendations for Enhancement.

Cheating incidents in 2006-07 led U.S. dental schools to heighten their efforts to enhance the environment of academic integrity in their institutions. The aims of this study were to document the measures being used by U.S. dental schools to discourage student cheating, determine the current incidence of reported cheating, and make recommendations for enhancing a culture of integrity in dental education. In late 2014-early 2015, an online survey was distributed to academic deans of all 61 accredited U.S. dental schools that had four classes of dental students enrolled; 50 (82%) responded. Among measures used, 98% of respondents reported having policy statements regarding student academic integrity, 92% had an Honor Code, 96% provided student orientation to integrity policies, and most used proctoring of final exams (91%) and tests (93%). Regarding disciplinary processes, 27% reported their faculty members only rarely reported suspected cheating (though required in 76% of the schools), and 40% disseminated anonymous results of disciplinary hearings. A smaller number of schools (n=36) responded to the question about student cheating than to other questions; those results suggested that reported cheating had increased almost threefold since 1998. The authors recommend that schools add cheating case scenarios to professional ethics curricula; disseminate outcomes of cheating enforcement actions; have students sign a statement attesting to compliance with academic integrity policies at every testing activity; add curricular content on correct writing techniques to avoid plagiarism; require faculty to distribute retired test items; acquire examination-authoring software programs to enable faculty to generate new multiple-choice items and different versions of the same multiple-choice tests; avoid take-home exams when assessing independent student knowledge; and utilize student assessment methods directly relevant to clinical practice.

Fitting form to function: reorganization of faculty roles for a new dental curriculum and its governance.

The College of Dentistry at the University of Illinois at Chicago has reorganized its predoctoral curriculum to better integrate biomedical, clinical, and behavioral sciences using a systems-based framework. The resulting D.M.D. curriculum features small-group discussions of patient scenarios that include orofacial, systemic, and professionalism learning objectives. Small-group learning is closely coordinated with laboratory, pre-patient care, and patient care experiences. Accordingly, the college has also reorganized its faculty roles to eliminate discipline-based silos and to better ensure program coherence. The new organizational structure is designed to improve coordination among faculty course teams that develop and administer individual courses, several units that provide curriculum resources and support services, and the curriculum committee, which is charged with governance of the curriculum as a whole. In addition, the new structure employs a system of reporting and planning relationships to ensure continuous monitoring and improvement of the curriculum. This article describes six principles that guide the new faculty roles structure, defines the various faculty roles and their coordinating relationships, presents diagrams depicting the organizational structures for curriculum governance, administration, and support, and discusses mechanisms for faculty support and continuous curriculum improvement.

Community-based dental education at the University of Illinois at Chicago.

Since 2002, community-based education at the University of Illinois at Chicago College of Dentistry (COD) has evolved from non-existent to a robust program that is an essential component of the predoctoral program. As part of the college's curricular innovation, community-based education has demonstrated alignment of the COD's mission with that of our parent institution, contributed significantly to student learning and preparedness, and enhanced clinic experiences and revenue. Student interest and support have been and continue to be enthusiastic and valued. The faculty has been generally supportive, but properly focused on demonstrated student learning outcomes. This faculty observation and evaluation, supported by evidence, has resulted in the faculty's rethinking traditional teaching and learning strategies, allowing innovative educational changes.

A clinically oriented complete denture program for second-year dental students.

The traditional preclinical complete denture prosthodontic curriculum relies predominantly on the laboratory (e.g., bench-type) component of the complete denture fabrication process. In most cases, this involves a passive model of student knowledge acquisition utilizing lectures and low-fidelity laboratory exercises. A recently implemented program in the College of Dentistry at the University of Illinois at Chicago challenges this educational paradigm by introducing an active learning environment for second-year students based on significant clinical exposure with patients. The result is a major shift of emphasis, first, from a purely technical/laboratory aspect of the discipline to patient-centered education and, second, from mastering individual phases of denture fabrication to understanding the entire process of edentulous patient care. To compare student outcomes in the new program with those in the traditional program, their performance overall and in three components of the final examination for each program were statistically compared. The results of the one-way ANOVA analysis show statistically significant improvement in the students' total score in the new program, including their performance on the written, practical, and OSCE portions of the final examination. This article describes the rationale, logistics, challenges, and advantages of the new educational model of the complete denture prosthodontics curriculum.

A model for selection and assessment of community-based sites for dental students' extramural clinical experiences.

As a recipient of the Robert Wood Johnson's Pipeline, Profession, and Practice: Community-Based Dental Education grant, the Extramural Education Program (EEP) at the University of Illinois at Chicago College of Dentistry was charged with developing partnerships with community-based oral health programs throughout Illinois. These programs are to be used for clinical service-learning rotations for fourth-year dental students, relying on the utilization of the dentists employed at the community site as preceptors for the students. Because the College of Dentistry had essentially no community-based service-learning experiences prior to the Robert Wood Johnson grant, procedures and protocols needed to be developed to standardize a process for site and preceptor selection. An administrative process was developed to engage, recruit, and partner with community-based oral health programs that provided direct clinical services. This article will discuss the development of criteria used to select sites and preceptors for extramural clinical rotations; the development of a set of standardized assessment instruments; and the credentialing process for community-based adjunct faculty that leads to the affiliation agreements. These community-based rotations have been integrated into the College of Dentistry curriculum as a required extramural service-learning course referred to as Extramural Clinical Experience (DADM 325).

Designing evaluation forms to facilitate student learning.

Most dental school instructors struggle to develop course evaluation criteria that can effectively be applied as valid and reliable learning instruments. Vague and unreliable learning assessments often lead to increased dissatisfaction among both faculty and students. Students complain about the "lack of faculty calibration," and faculty are often unable to adequately evaluate competence due to the need to provide an overall course grade by the end of the term. By systematically addressing Mackenzie et al.'s list of sixteen factors that contribute to faculty disagreements on student evaluation, we developed "Criteria for Writing Effective Evaluation Forms" as a guide for developing evaluation criteria. By using the guide for developing evaluation forms for student learning, course directors will have the components necessary to ensure validity and reliability of student assessment methodology. By providing students and faculty with clearly defined criteria and the training to apply those criteria, Mackenzie et al.'s concerns may be conquered.

Curriculum restructuring at a North American dental school: rationale for change.

The purpose of this article is to discuss how traditional dental school curricula are inconsistent with research in how learners learn. In the last ten years, there has been considerable discussion about the need for dental education reform, and innovative changes have occurred in the curricula of a number of U.S. dental schools. However, efforts in curriculum restructuring have been hindered by the lack of evidence that one specific curriculum design achieves outcomes superior to other designs. Moreover, there has been little discussion in the dental literature about how modern theories of learning can provide a sound rationale for change in dental education. Thus, it is important for those involved in curriculum reform to present the rationale for change based on the best available evidence. In this review, we summarize aspects of research on learning that seem applicable to dental education and outline ways in which curricula might be changed to become more consistent with the evidence.

Developing a group practice comprehensive care education curriculum.

In fall 2002 the University of Illinois at Chicago College of Dentistry implemented a Group Practice Comprehensive Care Clinical Education Curriculum. The primary responsibility for patient care has shifted in this comprehensive care curriculum from the students to the faculty and staff. Students have a primary responsibility for learning. This competency-based education curriculum utilizes a variety of student evaluation methods including self-evaluation, OSCE, and portfolio to verify competence. Formative evaluation methods are utilized in daily assessment of student performance. On-time graduation rates have increased from 60-70 percent to 96 percent, and regional board first-time pass rates have been maintained at 90+ percent. Overall predoctoral clinical productivity in the first full year of the program has increased by over 300,000 dollars.