An overview of case-based and problem-based learning methodologies for dental education.

Dental education has undergone significant curriculum reform in response to the 1995 Institute of Medicine report Dental Education at the Crossroads and the series of white papers from the American Dental Education Association Commission on Change and Innovation in Dental Education (ADEA CCI) first published in the Journal of Dental Education and subsequently collected in a volume titled Beyond the Crossroads: Change and Innovation in Dental Education. An important element of this reform has been the introduction into academic dentistry of active learning strategies such as problem-based and case-based learning. As an aide to broadening understanding of these approaches in order to support their expansion in dental education, this article reviews the major characteristics of each approach, situates each in adult learning theory, and discusses the advantages of case-based learning in the development of a multidisciplinary, integrated predoctoral dental curriculum.

A case study on development of an integrated, multidisciplinary dental curriculum.

Calls for fundamental reform of dental education were made twice in the twentieth century. More recently, spurred by the work of the American Dental Education Association's Commission on Change and Innovation in Dental Education (ADEA CCI), North American dental educators have again begun advocating for major curriculum reform in order to develop in students the higher order thinking skills required for the contemporary practice of dentistry. This case study describes the process of curricular reform at one school designed to move from a traditional siloed curriculum to one that uses case-based, integrated multidisciplinary courses to improve teaching and learning. The process was broad-based and comprehensive and included a schoolwide values clarification exercise and agreement on desired characteristics of an ideal graduate. Stakeholders agreed that the reform curriculum should incorporate inter- and multidisciplinary courses, case-based and active learning strategies, and concepts from adult learning theory. The new curriculum model is comprised of five unique but related curriculum "strands," each managed by a small group of interdisciplinary faculty content experts. Challenges in the development and implementation of the reform curriculum are discussed, and an assessment plan is presented.

Patient preference for a racially or gender-concordant student dentist.

Disparities in health and health care due to race and ethnicity are a national problem. One commonly proposed method to address disparities is to increase the number of underrepresented minorities in the health professions to serve the needs of growing minority populations. This position is based in part on the racial concordance hypothesis, an untested assumption that minority patients prefer to be treated by providers of the same race as themselves. The purpose of this study was to test the racial concordance hypothesis. Gender preference of dental patients was also investigated. One hundred twenty male and female Caucasian, African American, Hispanic, and Asian dental patients over eighteen were recruited from the reception area of a private dental school clinic in Northern California. Participants were randomly assigned to a treatment condition that gave them a choice between two equally qualified fictitious dental students that varied on race and gender. Participants were initially blinded to the study's purpose to preserve the authenticity of the choice decision. Results showed that 58 percent of the participants had no preference for the race or gender of their student dentist, but that some black and Hispanic patients preferred a racially concordant student dentist and some female patients preferred a gender-concordant student dentist. Hispanic females were especially likely to prefer racial and gender concordance. The findings suggest that the racial concordance hypothesis may not apply to choosing a dentist and thus may not be as strong an argument to justify efforts to increase diversity in dental schools as previously thought.

Applicant-interviewer gender concordance and the decision to enroll in dental school.

To increase the yield of females in the entering class, the executive admissions committee at a private West Coast dental school instituted gender-concordant applicant-interviewer dyads. Supported by Tajfel's social identity theory, members of the committee assumed that female applicants interviewed by female faculty interviewers were more likely to enroll than females interviewed by male interviewers. The purpose of this study was to test that assumption. Data were collected on all accepted applicants (n=1,192) and all faculty interviewers (n=43) for the 2001-05 entering classes and analyzed with chi square. Results revealed no relationship between applicant-interviewer gender concordance and the decision to enroll at the school. Although these findings suggest that applicant-interviewer gender concordance does not play a significant role in the enrollment decision, additional research is recommended on which factors are important to women in deciding to enroll at a particular dental school.

Use and perceived effectiveness of student support services in a first-year dental student population.

The purpose of this study was to determine the severity of problems common to the first year of dental school and to assess the use and perceived effectiveness of formal and informal peer and professional support programs in addressing those problems. First-year students at one California dental school were surveyed on the severity of problems encountered, support services used, and perceived effectiveness of services. Results indicated that the problems perceived as most serious by students in this sample were of an emotional nature relating to academic performance. Findings showed that students relied heavily on themselves and on informal advice from peers to handle problems and that they perceived these resources to be very effective. Findings also showed that low-ranking students used both formal and informal resources to resolve problems and that females used resources outside of the school more than males did. Results of the study offer some evidence to support providing both formal and informal peer and faculty support programs for first-year dental students. Results also provide insight into the use of peers and "self" to resolve problems common to the first year of dental education.