Does use of an electronic health record with dental diagnostic system terminology promote dental students' critical thinking?

The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the Dental Diagnostic System (DDS) terminology in the axiUm electronic health record (EHR). This collaborative pilot study had two aims: 1) to investigate whether use of the DDS terms positively impacted predoctoral dental students' critical thinking skills measured by the Health Sciences Reasoning Test (HSRT), and 2) to refine study protocols. The study design was a natural experiment with cross-sectional data collection using the HSRT for 15 classes (2013-17) of students at three dental schools. Characteristics of students who had been exposed to the DDS terms were compared with students who had not, and the differences were tested by t-tests or chi-square tests. Generalized linear models were used to evaluate the relationship between exposure and outcome on the overall critical thinking score. The results showed that exposure was significantly related to overall score (p=0.01), with not-exposed students having lower mean overall scores. This study thus demonstrated a positive impact of using the DDS terminology in an EHR on the critical thinking skills of predoctoral dental students in three COHRI schools as measured by their overall score on the HSRT. These preliminary findings support future research to further evaluate a proposed model of critical thinking in clinical dentistry.

Cone beam computed tomography in dentistry: what dental educators and learners should know.

Recent advances in cone beam computed tomography (CBCT) in dentistry have identified the importance of providing outcomes related to the appropriate use of this innovative technology to practitioners, educators, and investigators. To assist in determining whether and what types of evidence exist, the authors conducted PubMed, Google, and Cochrane Library searches in the spring of 2011 using the key words "cone beam computed tomography and dentistry." This search resulted in over 26,900 entries in more than 700 articles including forty-one reviews recently published in national and international journals. This article is based on existing publications and studies and will provide readers with an overview of the advantages, disadvantages, and indications/contraindications of this emerging technology as well as some thoughts on the current educational status of CBCT in U.S. dental schools. It is the responsibility of dental educators to incorporate the most updated information on this technology into their curricula in a timely manner, so that the next generation of oral health providers and educators will be competent in utilizing this technology for the best interest of patients. To do so, there is a need to conduct studies meeting methodological standards to demonstrate the diagnostic efficacy of CBCT in the dental field.

Rubrics 101: a primer for rubric development in dental education.

Identifying and implementing effective methods for assessing dental student performance are ongoing challenges for dental educators. Questions related to grading and assessment are common among faculty and students alike. Faculty members who are well-trained clinicians or scientists often have little formal training in education. In addition, assessment of performance brings with it an element of subjectivity. Questions about assessment and grading are most likely to arise when expectations are unclear or the rationale for the grade awarded is not articulated. The authors propose that one solution to assessment dilemmas can be found in the use of rubrics: scaled tools with levels of achievement and clearly defined criteria placed in a grid. Rubrics establish clear rules for evaluation and define the criteria for performance. Rubrics speak to both teaching and learning expectations and outcomes and can provide faculty members with a tool that can be useful in evaluating dental student performance. Rubrics can also provide students with clear expectations of performance, an opportunity to self-assess, and timely, detailed feedback. The purpose of this article is to define a rubric, apply the steps of rubric development as described in the educational literature to dental student assessment, present two examples of rubric implementation for assessing student progress toward competence, and recommend electronic resources for rubric development.

Teaching of color in predoctoral and postdoctoral dental education in 2009.

OBJECTIVES: The goal of the study was to determine the current status of the teaching of color in dental education at both the predoctoral (Pre-D) and postdoctoral (Post-D) levels. METHODS: A cross-sectional web-based survey, containing 27 multiple choice, multiple best and single best answers was created. Upon receiving the administrative approval, dental faculty involved in the teaching of color to Pre-D or Post-D dental students from around the world (N=205), were administered a survey. Statistical analysis of differences between Pre-D and Post-D was performed using Chi-square test (α=0.05). RESULTS: A total of 130 responses were received (response rate 63.4%); there were 70 responses from North America, 40 from Europe, 10 from South America, nine from Asia and one from Africa. A course on "color" or "color in dentistry" was included in the dental curriculum of 80% of Pre-D programs and 82% of Post-D programs. The number of hours dedicated to color-related topics was 4.0±2.4 for Pre-D and 5.5±2.9 for Post-D, respectively (p<0.01). Topics associated with tooth color, shade matching method, tooth whitening, and teaching of appearance parameters other than color, were frequently taught. CONCLUSIONS: Significant differences were recorded between the number of hours dedicated to teaching of color at predoctoral and postdoctoral level. The same is true for the prosthodontics and restorative courses, teaching on negative after images; color rendering index, Bleachedguide 3D-Master shade guide, digital camera and lens selection, composite resins, and maxillofacial prosthetic materials. Except for the restorative courses and composite resins, significantly higher results were recorded for Post-D programs. Vitapan Classical and 3D-Master were the most frequently taught shade guides.

Developing dental faculty for the future: ADEA/AAL Institute for Teaching and Learning, 2006-09.

This report summarizes the history and curriculum of the American Dental Education Association/Academy for Academic Leadership Institute for Teaching and Learning (ADEA/AAL ITL) Program for Dental School Faculty, describes participant feedback, and reviews how the program serves the faculty development initiatives of the American Dental Education Association. The fifty-hour program (6.5 days), conducted in two phases at collaborating dental schools, enhances core academic competencies of new and transitional faculty, including faculty members whose responsibilities include predoctoral, allied, and postdoctoral dental education. The program's mission is to prepare participants to become more effective teachers and develop other skills that will facilitate confidence, job satisfaction, and professional growth in the academic environment. From 2005 to 2009, 174 individuals graduated from the program, representing forty-three schools of dentistry in the United States and Canada and twenty-nine private practices. A total of forty scholarships have been awarded to participants by the American Academy of Periodontology Foundation, the American Academy of Pediatric Dentistry, and the American Association of Orthodontists. In an online survey completed by 75 percent of ADEA/AAL ITL participants, 99 percent indicated they were positive or highly positive about their learning experience in this faculty development program. Ninety-six percent stated that the program had been important or very important in their effectiveness as a teacher. In 2010, the program will be held at the University of North Carolina at Chapel Hill School of Dentistry, with phase I occurring on August 19-22, 2010, and phase II on October 22-24, 2010. In summary, the ADEA/AAL ITL is addressing an unmet need through a formal professional development program designed to help new and potential faculty members thrive as educators and become future leaders in academic health care.

Team-based learning using an audience response system: an innovative method of teaching diagnosis to undergraduate dental students.

A team-based learning (TBL) approach was used to facilitate student learning and performance in a sophomore preclinical endodontic course. TBL is based upon the division of a class into small groups of students using a problem-based learning approach. The purpose of this project was to improve student ability to diagnose diseases utilizing TBL combined with an audience response system (ARS). Three measures were used to assess the outcomes: 1) pre- and posttest scores, 2) a diagnostic skills assessment during the final examination, and 3) an attitudinal survey completed by the students. At the beginning of the course, second-year students (n=64) were evaluated to determine entry-level knowledge. Six groups of ten to eleven students each were pretested, followed by a parallel posttest following the implementation of the TBL experience. Students' performance on the posttest (63.4 percent) showed improved results when compared to the pretest (36.9 percent). Students also exhibited improved diagnostic skills with the final examination. The results of the students' attitudinal survey indicated an 80 percent agreement that TBL enhanced their powers of critical analysis.

Personality traits of endodontic residents indicate potential for becoming endodontic faculty.

Dental schools across America are challenged by the shortage of qualified faculty to fill vacant positions. This project, conducted through survey methodology, focused on obtaining a basic understanding of the personality types that seek out and maintain positions as full-time endodontic educators and compared those educators with endodontic residents to define similarities and differences that could lead to strategies to recruit those residents into academic endodontic education to assist in alleviating the faculty shortage in dentistry. All full-time endodontic faculty and residents were invited to participate. The Myers Briggs type indicator form M was administered electronically to faculty and postgraduates/residents. A 38.8% faculty and 21.3% resident response rate was achieved. Survey results were analyzed by using description statistics and chi-square tests. Results of the study indicate that there are parallel personality preferences of residents and faculty resulting in recommendations of early identification of academic interest, structured mentoring, faculty development of residents, and the implementation of debt-reduction strategies to ease entry into academic dentistry.

Matching student personality types and learning preferences to teaching methodologies.

The purpose of this study was to identify teaching styles that complement the learning preferences of undergraduate dental students while enhancing the quality of patient care. A formidable challenge to reform in dental education has been overcoming the resistance by faculty and administration to recommended changes. The organizational structure of dental institutions, with their independent departments, makes obtaining consensus on educational issues difficult. For beneficial change to occur, clear evidence of the benefits to all within the organization must be presented. The objectives of the study were to 1) identify the most common personality types among first- and second-year undergraduate dental students at the University of Texas Dental Branch at Houston using the Myers-Briggs Type Indicator (MBTI); 2) identify the learning preferences of these personality types; and 3) determine a more effective approach to teaching clinical dentistry based upon student personality types and learning preferences. Four common personality types were identified among respondents: ISTJ, ESFJ, ESTJ, and ISFJ, with a predisposition for Sensing (S) (desire for facts, use of senses) over Intuition (N) (look for possibilities, relationships) and Judging (J) (prefers decisiveness, closure) over Perceiving (P) (desire flexibility, spontaneity). The most common occurring personality type, ISTJ, represents an Introverted, Sensing, Thinking, Judging individual. Specific clinical curricular techniques that would appeal to these common personality types are identified, and an explanation of their benefit is provided. Results of this study demonstrate the importance of faculty understanding and acknowledging different student personality types and related learning preferences as a way to initiate improvement of undergraduate dental education, promote student motivation, and allow for an expression of learning style preference.

A model for clinical credentialing of dental school faculty.

Committed to the premise that the same standards of review for clinical practice may be applied to clinical teaching, The University of Texas Health Science Center Dental Branch at Houston began credentialing clinical faculty in 1997 as part of its quality assurance and risk management program, one of the first dental schools in the country to do so. Credentialing, modeled after health care institutions such as hospitals, is general and procedure-specific involving the review of qualifications such as licensure, training, education, experience, and performance of professional practitioners; measuring those qualifications against pre-established criteria; and granting of "clinical privileges" to clinical faculty to perform or supervise procedures for which they are deemed qualified, based on that review. The development process included the leadership of the Quality Assurance and Risk Management Committee who met with all interested parties, explained the rationale and justification for credentialing, and successfully gained the support of the clinical department chairs, clinical faculty, faculty senate, and the administration of the school in implementing the credentials process. Evaluation of this process indicates that it has been useful in providing a mechanism to address a variety of patient care and clinical education issues such as faculty competency, compliance, and accommodations through a peer review process.

Diversity, cultural sensitivity, unequal treatment, and sexual harassment in a school of dental hygiene.

PURPOSE: The purpose of this study was to assess the cultural environment in the School of Dental Hygiene at the University of Texas Dental Branch (UTDB) at Houston. METHODS: A 36-item questionnaire was developed and administered to first- (DH1; n=34) and second-year (DH2, n=33) dental hygiene students. Questions explored satisfaction with diversity and interactions with faculty, staff, patients, and other students relative to gender, ethnicity/race, age, and sexual orientation. Data were analyzed using 2x3 and 2x5 contingency tables to calculate the chi square test statistic. RESULTS: Ninety-one percent of the 67 DH students responded. While the majority of students reported satisfaction with the cultural diversity and their interactions at UTDB at Houston, 76% of the DH2 students and 62% of the DH1 students reported that the curriculum did not prepare them to work with patients whose primary language is not English. Eighty-two percent of DH1 students and 59% of DH2 students reported that the curriculum did not prepare them to work with patients with different sexual orientations and religious backgrounds. The DH2 students reported unequal treatment by faculty of another gender (24%) and ethnicity (21%), and sexual harassment by other students (6%). DH1 reported 6%, 12%, and 0%, respectively. CONCLUSION: Data indicate that dental hygiene students in the UTDB at Houston dental hygiene program experienced unequal treatment and sexual harassment by either faculty, staff, patients, or other students. To create a more culturally sensitive environment, the students, faculty, and staff could benefit from training on diversity, cross-cultural competence and awareness, and sexual harassment prevention and management. The dental hygiene curriculum should be reviewed for the inclusion of topics related to diversity, cultural competence, and sexual harassment.