Characteristics of effective clinical teachers identified by dental students: a qualitative study

Factors Influencing the Students’ Perception of Lecturing Skills in Saudi Dental Schools

Introduction:

Students' feedback is vital in improving the teaching and learning process in dental schools across the globe, including Saudi Arabia.

Objective:

This study explores the factors influencing the students' perception of faculty members' lecturing skills in Saudi dental schools. It also determines whether there is any gender difference in their perception of lecturing skills.

Methods:

The exploratory study design was utilized to evaluate the factors influencing the dental students' perception of lecturing skills at the selected Saudi dental schools (n=4). This study included the complete student population (n=530) of the undergraduate dental program at those schools during the academic year 2020-2021. A questionnaire titled “Students Survey of Lecturing Skills (SSLS)” was distributed to the students through an online tool. The data of the completed questionnaires (n=426) was subjected to statistical analysis using statistical software.

Results:

The structural equation modeling (SEM) analysis revealed that five factors of SSLS, namely, Organization and Structure of the lectures (OS)”, “Lectures Effectiveness on Learning and Understanding (LEL)”, “Interest and Motivation (IM)”, “Professional Interaction (PI)”, and “Presentation and Classroom Atmosphere (PC)” are vital to evaluate the dental students' perception towards lecturing skills. Also, these five factors have significantly influenced the students' perception of faculty members' lecturing skills in Saudi dental schools. Overall, female dental students are highly satisfied than the male students in regard to their faculty members' lecturing skills.

Conclusion:

OS, LEL, IM, PI, and PC are the significant factors influencing dental students' perception of lecturing skills. These factors can be considered while assessing teaching quality and framing effective strategies for enhancing it at Saudi dental schools.

Lecturer Competence from the Perspective of Undergraduate Psychology Students: A Qualitative Pilot Study

Understanding what students mean by lecturer competence can be crucial in order to recognise indicators with which to assess these competences, improve the quality of university teaching and support lecturers in undertaking their role appropriately. This qualitative pilot study aimed to explore the meaning of competence in a convenience sample of Italian undergraduate psychology students (N = 122). We collected free-associations about what “lecturer competence” actually means for the students. The data corpus underwent a lexical Correspondence Analysis (CA) using the ASPAR procedure of SPAD-T. Two factors were extracted: “socio-emotional dimension” and “task specialist.” Students associated the competent lecturer with those who was involved with the achievement of the task goals, on the one hand or those who was engaged in the group’s maintenance, on the other. Furthermore, Cluster Analysis identified four clusters: (1) the captivating lecturer; (2) the lecturer oriented to both task and socio-emotional aspects; (3) the rigorous lecturer; and (4) the benevolent lecturer. The preliminary results of this pilot study showed an articulated and multi-dimensional representation of the meanings of lecturer competence from the students’ point of view and lay the foundations for a broader quantitative study on the conceptions concerning lecturer competence.

Clinical supervisors' reflections on their role, training needs and overall experience as dental educators

OBJECTIVES

The aims of this study were to understand the views of clinical supervisors overseeing final year dental students and investigate their perceived role, level of support and training available, and ways to improve the supervisory experience.

METHODS

Clinical supervisors who oversaw fifth-year dental students in 2019 were invited to participate in an online survey. Respondents who indicated their willingness to participate were contacted for a semi-structured interview which were analysed using Constant Comparative Methodology.

RESULTS

Sixteen supervisors completed the survey, with a response rate of 73%. Respondents reported low levels of formal training in clinical supervision (38%) and most (75%) felt further training would be beneficial for their role. While nearly all (94%) reported they had developed as a dental professional through supervision, most (63%) were not positively encouraged to develop a career as a supervisor, with tensions between health service delivery and academia identified as a key challenge. The driving motivator to supervise was a desire to teach (62.5%). Seven (44%) participants completed the semi-structured interview. Participants' perception of their role varied depending on career stage and clinic location. Lack of recognition and defined career pathways were the biggest challenges reported by participants.

CONCLUSION

Retention and morale of supervisors may increase with better-defined career pathways and meaningful professional development opportunities. There is a need to develop tailored training programs for supervisors that enable them to teach critical thinking and clinical judgement while ensuring patient safety.

The effect of instructors' clinical experience on professional socialization from the perspective of nursing students: A phenomenological qualitative study

Nursing students spend efforts to be familiar with their professional roles and professional values and to understand professional behaviors, functions, and values correctly in clinical practices. First and second-year nursing students are in the early stages of professional socialization in clinical practice. In the third year, students start to reach a level at which they are aware of the professional behaviors of instructors in clinical practice in terms of professional socialization. This study aimed to determine how the effect of instructors on the professional socialization of students in clinical practice was perceived by the students. The study used a qualitative design based on Heidegger's hermeneutic phenomenological approach. First, the content of the questions in the interview form and the aim of the study were explained to the students, and then the interviews were conducted with 10 students who agreed to participate in face-to-face in-depth interviews. The data were analyzed using van Manen's thematic analysis and three themes and seven sub-themes were determined. The themes of the study were as follows: (1) It may make professional socialization easier or difficult (subthemes: "It is important to be aware of my presence"; "Unfair practices related to marks and threat with marks"), (2) Instructors' communication with nurses affects us (subthemes: "Positive atmosphere of care", "Acceptance in the clinic"), (3) I am aware of our instructors with clinical experience (subthemes: "Like someone in the clinic", "Role model with care behaviors", "Like carrying water in your palms"). In light of the results of this study, it has been understood that the clinical experience of the instructors is important. In addition, the importance of clinical experience in the employment of instructors has emerged.

Measuring and assessing the competencies of preceptors in health professions: a systematic scoping review

BACKGROUND

In healthcare, preceptors act as a role model and supervisor, thereby facilitating the socialisation and development of the preceptee into a professional fit to practice. To ensure a consistent approach to every preceptorship experience, preceptor competencies should be measured or assessed to ensure that the desired outcomes are achieved. Defining these would ensure quality management and could inform development of an preceptor competency framework. This review aimed to evaluate the evidence for preceptor competencies and assessment in health professions.

METHODS

This study followed the PRISMA ScR scoping review guidelines. A database search was conducted in Embase, Medline, CINAHL and IPA in 2019. Articles were included if they defined criteria for competency, measured or assessed competency, or described performance indicators of preceptors. A modified GRADE CERQual approach and CASP quality assessment were used to appraise identified competencies, performance indicators and confidence in evidence.

RESULTS

Forty one studies identified 17 evidence-based competencies, of which 11 had an associated performance indicator. The competency of preceptors was most commonly measured using a preceptee completed survey (moderate to high confidence as per CERQual), followed by preceptor self-assessment, and peer-assessment. Preceptee outcomes as a measure of preceptor performance had good but limited evidence.

CONCLUSIONS

Competencies with defined performance indicators allow for effective measurement and may be modifiable with training. To measure preceptor competency, the preceptor perspective, as well as peer and preceptee assessment is recommended. These findings can provide the basis for a common preceptor competency framework in health professions.

Dental Faculty, Student, and Alumni Perceptions of Happiness and Life Satisfaction in Dental School: Foundations for Resilience and Well-Being

This study examined happiness and satisfaction as possible foundations for long-term well-being and resilience in dental education. Psychological research has found that respect, camaraderie, and trust help define well-being and that resilience is built with these supportive influences. The aims of this study were to assess if happiness and life satisfaction reported by one U.S. dental school's faculty, students, and alumni also enhanced their perceived well-being and resilience and to determine the factor that most affected the participants' happiness. Email and hard copy surveys were distributed in 2018 and 2019 to all 71 full-time preclinical and clinical faculty members, 572 students in all four years, and 143 alumni who graduated in 2018 (total N = 786). Overall, 471 responded; response rates by group were as follows: faculty 87.3% (N = 62), students 65.9% (N = 377), and graduates 22.4% (N = 32). Of the three groups, responding faculty members reported having the highest levels of happiness in life (92.0%) and job satisfaction (90.3%). In the highest percentage reported, 90.2% of D4 students reported that the level of trust and respect they received from clinical faculty members contributed most to their happiness. The lowest level of happiness among the groups (71.0%) was reported by the D2 students. These results suggested that perceived well-being translated to happiness among the participants in our study. More research is needed to understand the relationship among positive environments, well-being, and provider resilience in dental education.

Attributes of Effective Clinical Teachers in Dental Hygiene Education

Many health professions have identified characteristics of an effective clinical instructor and used this information to create tools to measure clinical teaching effectiveness (CTE) in their disciplines. However, minimal research has been conducted to explore the attributes of an effective clinical instructor in dental hygiene education. The aim of this study was to identify the attributes of dental hygiene clinical instructors associated with effective teaching. This study used a Delphi research design to iteratively survey an expert panel of 14 dental hygiene instructors in dental hygiene programs from 13 U.S. states in 2019. A cumulative overall response rate of 89.3% was achieved after conducting three survey rounds. The results showed statistically significant consensus on 91 CTE characteristics. Participants agreed that effective clinical instructors should possess the ability to clearly communicate, foster interpersonal relationships, encourage a climate of mutual respect, and act as good role models who are emotionally intelligent, caring, trustworthy, fair, honest, and supportive. There was also agreement that effective clinical instructors were those who created a safe learning environment centered on collaboration, motivation, guidance, and positive corrective feedback. These results were similar to those identified in other health professions. However, there is a need for dental hygiene education to develop its own CTE assessment tool for use in professional development.

Self-perceptions about the profession of dentistry-comparisons between Lithuanian and Polish University graduating students

AIM

To examine the perceptions and overall satisfaction about the dental profession amongst the final-year student cohorts from the Lithuanian and Polish universities.

MATERIAL AND METHODS

For the Lithuanian cohort, the response rate was 95% (N = 143) and for the Polish cohort it was 99% (N = 123). The survey included a pre-tested questionnaire with multiple questions from three domains: (a) Sociodemographic, (b) Influences of others and (c) Dentistry Profession.

RESULTS

Polish university students were older (25.3 ± 2.6 years) than Lithuanian students (23.5 ± 1.6 years), more Lithuanian (83.1%) students were single compared to Polish cohort (34.7%), and more students graduating in Poland (43.4%) were males compared to the Lithuanian students (26.6%). In both countries, students were mostly influenced towards their choice of dentistry by their parents/relatives and positive experiences. Similar profession-related dimensions were identified for student from both countries: (a) the prestige of the profession, (b) job-related security, and (c) self-realisation. Satisfaction with a profession differed substantially between the two student cohorts, but none of the sociodemographic predictors explained this variation satisfactorily.

CONCLUSIONS

Sociodemographic differences were found between the students from Lithuanian and Polish universities. Yet, both student cohorts were similarly influenced towards choosing dentistry. The profession's prestige, job security and self-realisation were the most important profession-related dimensions. Polish university students were more satisfied with the profession than Lithuanian students.

An investigation of dental students' perceptions about the characteristics of effective instructors and their related factors

BACKGROUND

The characteristics of effective teachers can be used to improve student learning, support their academic achievement outcomes and promote faculty development and career advancement.

OBJECTIVES

To assess dental students' perceptions about the characteristics of effective instructors and related factors.

MATERIALS AND METHODS

This cross-sectional study analysed data collected from students at a dental college in Saudi Arabia. A pilot-tested questionnaire with satisfactory internal consistency was distributed amongst all students. The questionnaire contained 21 items related to the characteristics of effective instructors on a 5-point Likert-type scale. Student's t test was performed to analyse the association of factors like gender, last year's GPA, academic year, paternal income, education and employment with three highly rated items of the characteristics of effective teachers.

RESULTS

The response rate was 85.4%. There were 53.6% female and 46.4% male students in the study. The provision of learning resources (mean 4.3 ± 1.06), demonstration of honesty, ethics and integrity (mean 4.28 ± 0.99) and showing respect and caring attitude (mean 4.24 ± 0.94) were three most highly rated characteristics of effective instructors. Using the latest technology, acting as a role model and maintaining class discipline were the least rated traits of good teachers. A significantly higher percentage of female students considered these three items more important than male students (P < 0.05). The students with last year GPA > 4 considered providing learning material as an attribute of effective teacher significantly more important than the students with GPA ≤ 4 (P < 0.001). In addition, the characteristics of effective instructors (75.1%) were considered more important in providing students with rewarding learning experience than their teaching experience (15.4%) and educational attainment (9.5%).

CONCLUSION

The most important attributes of effective teachers included providing learning resources, demonstrating honesty/integrity and showing respect/care.

Looking beneath the surface of a preceptor-training programme through a realist evaluation

South Africa's department of health devoted themselves to the clinical nursing education and training model, which indorses preceptors as essential stakeholders to promote competence in students. A preceptor-training programme was developed that build on this model and implemented through an intervention. The initial programme theory hypothesised that trained preceptors would promote support and develop competence in students in comparison to untrained preceptors. Results showed a poor outcome because few preceptors participated and a high student attrition rates. The authors then posed the question "Why did the preceptorship training programme not work?" This article offers insight into the context, mechanism, and outcome of the preceptor-training programme through a realist evaluation. Reflective field notes, gathered during the intervention, were used and gave insight regarding how, for whom, and under which circumstances the programme could work and offered a refined programme theory for preceptorship. The main conclusion drawn showed that a preceptor-training programme alone is not the sole determining factor to ensure preceptors' motivation to transfer their learning; a systems approach, ensuring the effectiveness of the programme, should be followed. Reflection on findings indicated the implementation context as a major determining factor of the training programme.

Patterns of verbal interaction and student satisfaction within a clinical setting: A video-enhanced observational study

BACKGROUND

The increasingly competitive global higher education sector recognises the impact of teaching quality and a strong student voice. This means that student satisfaction is under increasing scrutiny; however, little is known about how clinical teachers actually teach. At present, the relationship between actual patterns of individual dental student-clinician interaction and student satisfaction is unclear.

AIM

To investigate the relationship between patterns of verbal interaction and individual student satisfaction, during dental clinical teaching encounters.

METHODS

A total of 150 patterns of verbal interactions between Stage 2 (BDS and Hygiene and Therapy, n = 86) students and clinical teaching staff were recorded within a clinical skills environment in a Dental School in the United Kingdom. Verbal interaction analysis (VIA) was used as a basis for recording full verbal interactions between students and skills teachers.

RESULTS

The length of the encounter, the amount of praise/encouragement, the level of criticism, the number of questions asked and the proportion of student talk were significant predictors of student satisfaction. The proportions of time spent with the teacher talking, time spent in silence and time spent examining the patient or clinical work were not significant predictors of student satisfaction. Further, the degree to which the teacher lectured or gave direction was not a significant predictor of student satisfaction.

CONCLUSIONS

A number of observed behaviours correlated significantly with increased satisfaction. Praise and the acceptance of student ideas are required to offset high levels of criticism, and the encounter seems to require structure from the clinician with an emphasis on indirect influence rather than just lecturing.

Monitoring preceptors' supportive role: A measuring instrument for increased accountability

PURPOSE

This article describes the development of a measuring instrument to monitor support offered by preceptors during their accompaniment of students in clinical facilities.

DESIGN

A quantitative methodological study design was used to develop the instrument.

METHODS

Data were collected by means of a self-completed questionnaire. Total sampling of 192 undergraduate nursing students was done. Descriptive data analysis was conducted regarding the biographical characteristics, Cronbach's alpha was computed to determine the reliability, and an exploratory factor analysis was done to describe the construct validity of the developed instrument.

RESULTS

The Cronbach's alpha of 0.98 indicates high reliability and high internal consistency. Three constructs regarding clinical support, namely cognitive-, emotional- and system support were identified by means of the exploratory factor analysis.

CONCLUSION

The new conceptualisation of support gives insight into the value of the preceptor's role. The instrument designed for this study could be used to assess and monitor the support offered by preceptors while they accompany students in clinical practice.

CLINICAL RELEVANCE

Considering the need to strengthen nursing and midwifery education systems, this instrument contributes to measuring and monitoring clinical accompaniment of students by preceptors.

Effect of individual structured and qualified feedback on improving clinical performance of dental students in clinical courses-randomised controlled study

AIM

Analysis of the effect of individual structured and qualified feedback (FB) on practical skills development of dental students during clinical courses.

METHODS

Fifty-three final-year dental students at Jena University Hospital participated in this prospective randomised controlled interventional study. Two calibrated assessors evaluated 128 pre- and post-assessments of 4 different dental treatment steps performed by dental students during the integrated clinical course in restorative dentistry and prosthodontics and the clinical course paediatric dentistry. The assessment included direct observation, graded and non-grading evaluation and was documented with a specific FB assessment tool. Dental students in the intervention group (IG) received an elaborated, structured and qualified FB after the pre-assessment that focussed on individual strengths and weaknesses, providing specific suggestions for improvement and establishing a personal learning goal. Participants were randomly allocated to the IG and the control group (CG).

RESULTS

In both groups, dental students significantly enhanced their performance, but the difference was higher in the IG than in the CG. Large effect sizes (ES) were observed in all observed items, but FB had largest effect size in improving technical skills (ES = 1.6), followed by management (ES = 1.3) and communication skills (ES = 0.8). Factors with the highest influence on FB in enhancing dental students' clinical performance were their insight into their own mistakes or omissions, the observed dental treatment step and the duration of FB.

CONCLUSION

Individual structured and qualified FB is an effective method to enhance dental students' professional performances and to individually guide the learning process.

Psychosocial student functioning in comprehensive dental clinic education: A qualitative study

INTRODUCTION

The aims were to describe first-year clinical dental students' psychosocial experiences in a known well-functioning comprehensive clinic teaching group (F+Grp) and a known dysfunctional group (Dys-Grp) and, thus, discover and describe phenomena related to psychosocial functioning of students. These groups were compared and contrasted regarding negative stress symptoms, perfectionism and coping with stress.

METHODS

Eight female dental students (mean 26 years old), four in each group, were interviewed after the first clinical year about learning and emotional experiences. The students also rated their perceived stress using a 0-10 scale, where 0 is no stress, and 10 is highest stress. Qualitative analyses involved searching for recurring themes and discovery of categories of clinical and social functioning. All 8 students were revisited as dentists after 8 years and filled out a 15-item survey as longitudinal validation of their first-year clinical experiences and to estimate group consensus and informant accuracy.

RESULTS

Both groups suffered from negative stress symptoms attributed to lack of time for clinical tasks, worries about work quality with confusion about their own expectations and worries about how others perceived them. Dys-Grp experienced higher negative stress and maladaptive perfectionism and described crying behaviours, withdrawal and unwillingness to cooperate with others. In contrast, students in F+Grp provided rich content about mutual cooperation related to social networking and positive support. The 8 subjects exhibited high internal consistency (α  =  .98) in their responses to the follow-up survey about their first year of clinic.

CONCLUSIONS

The comprehensive care teaching clinic environment with students working in groups appeared to provide a possibility for students to support each other for improved stress coping. Unfortunately, the opposite also occurred. Positive, supportive teacher supervision of student challenges related to perfectionism and stress is crucial and requires specific attention.

Encouraging intrinsic motivation in the clinical setting: teachers' perspectives from the self-determination theory

INTRODUCTION

Self-determination theory postulates that the three basic psychological needs of autonomy, competence and relatedness have to be satisfied for students to achieve intrinsic motivation and internalisation of autonomous self-regulation towards academic activities. Consequently, the influence of the clinical teaching environment becomes crucial when satisfying these needs, particularly when promoting or diminishing students' intrinsic motivation. The aim of this study was to describe and understand how clinical teachers encourage intrinsic motivation in undergraduate dental students based on the three basic psychological needs described by the self-determination theory.

METHODS

A qualitative case study approach was adopted, and data were collected through semistructured interviews with nine experienced undergraduate clinical teachers of one dental school in Santiago, Chile. Interview transcripts were analysed by two independent reviewers using a general inductive approach.

FINDINGS

Several themes emerged outlining teaching strategies and behaviours. These themes included the control of external motivators; gradual transference of responsibility; identification and encouragement of personal interests; timely and constructive feedback; delivery of a vicarious learning experience; teamwork, team discussion, and presence of a safe environment, amongst others. Overall, teachers stressed the relevance of empowering, supporting and building a horizontal relationship with students.

CONCLUSIONS

Our findings regarding dental education expand on the research outcomes from other health professions about how teachers may support students to internalise behaviours. An autonomy-supportive environment may lead students to value and engage in academic activities and eventually foster the use of an autonomy-supportive style to motivate their patients.

Impact of Registered Dietitian Expertise in Health Guidance for Weight Loss

BACKGROUND & OBJECTIVES

Expertise of registered dietitians (RDs) is important for health guidance but has been poorly evaluated. We evaluated the kind of RD expertise that would improve their skills.

DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS

This study was a post-hoc analysis of our randomized controlled trial, which compared the weight change between participants using the web-based self-disclosure health support and those using the email health support. Healthy men and women aged 35-64 years with a body mass index (BMI) of > = 24.5 kg/m2 were recruited for this study. We evaluated the relationship of RD expertise indicators including the duration of working as an RD, the experience of health counseling, and membership in the Japan Dietetic Association (JDA) with the weight loss of study participants. The primary endpoint was the change in body weight. Comparison of changes in body weight by the RD expertise indicators was evaluated using analysis of covariance.

RESULTS

A total of 175 participants were eligible for analyses. Changes in body weight were significantly greater when they were supported by the RDs in the routine counseling group than when supported by the RDs in the non-routine counseling group (-1.8 kg versus -0.4 kg, fully adjusted P = 0.0089). Duration of working as an RD and JDA membership did not significantly affect changes in body weight.

CONCLUSIONS

Among some indices of RD experience, the experience of providing routine experience of health counseling was associated with weight loss.

Faculty development for clinical teachers in dental education

Dental education has been reviewed, and suggestions for further enhancement include the implementation of faculty development activities to enhance teaching and learning environments.

PURPOSE

The aim of this study was to gain insight into the participants' perceptions of outcomes of faculty development for clinical teachers and clinical learning environments as well as into the sustainability of such outcomes.

METHODS

The program was organized in the form of (i) a 2-day seminar; (ii) collegial supervision and development projects; and (iii) a 1-day follow-up seminar. The participants' perceptions from the five-first programs were studied. A Web-based questionnaire was sent to all participants, that is 3-27 months after completion of the program (follow-up survey).

RESULTS

The outcomes of the program (response rate 70%) indicate a strong impact of the program on the clinical teachers' competence and on the clinical learning environments. The teachers report that they think more about what their students really learn, have become more conscious about how they supervise and have been stimulated to become better teachers. The learning environment as well as collaboration, and calibration between teachers have improved. The novice teachers report greater benefits than do the experienced teachers. The participants initiated a variety of development projects during the program. The majority of the participants continued the development activities.

CONCLUSIONS

The faculty development program presented confirms that faculty development activities for clinical teachers based on theories of learning and experiences documented in the literature can be implemented with positive outcomes for individual teachers and for the learning environments.

How to encourage intrinsic motivation in the clinical teaching environment?: a systematic review from the self-determination theory

PURPOSE

Internalization of students' motivation towards an intrinsic form is associated with increased interest, commitment, learning, and satisfaction with education. Self-Determination theory postulates that intrinsic motivation and autonomous forms of self-regulation are the desired type of motivation; as they have been associated with deep learning, better performance and well-being. It claims three basic psychological needs have to be satisfied in order to achieve intrinsic motivation. These are the needs for autonomy, competence and relatedness. This study aims to provide a review on how these basic psychological needs are encouraged in undergraduate students so they can be transferred to the clinical teaching environment.

METHODS

Electronic searches were performed across four databases (Medline, Embase, PsycINFO, and ERIC), relevant journals, and retrieved bibliography of selected articles. In total, searches produced 4,869 references, from which 16 studies met the inclusion criteria.

RESULTS

Main themes were coded in three categories: The support of autonomy, competence and relatedness. The research-based evidence appears to be of reasonable quality, and indicates that teachers should work to satisfy students' basic psychological needs to foster internalization of self-regulation. Our findings suggest that teachers should interact with students in a more 'human centred' teaching style, as these actions predict motivational internalization. Several themes emerged from different contexts and further investigation should expand them.

CONCLUSION

This review identified actions that clinical teachers could implement in their daily work to support students' self-determination. Autonomy supportive teaching in health professions educations would benefit students and may actually result in more effective health care delivery.

Praxis teaching in the ambit of learning assessment of endodontics in a Chilean university

The practice of assessing must ensure that the outcome of the process be a reflection of the learning achieved by students. The aim of this study was to describe the essential attributes of the praxis teacher in the area of Endodontics Learning Evaluation, in the School of Dentistry at the Universidad de Concepción, Chile. This study is designed to diagnose the reliability and objectivity of assessing the learning process, as a framework for innovation, and with a focus on evaluating endodontics skills. This hermeneutic study has a qualitative methodology. It was based on in-depth semi-structured interviews applied to 14 students and 5 teachers, and two focus groups consisting of eight students each. When the study was conducted, the research findings indicated that the evaluation process was not objective and lacked established criteria, and especially a guide to determining the skills. The theoretical evaluation was only summative. The formative role was not formally established. The subjects answered mostly psychometric instruments by multiple choice and with short or extended answers. It was concluded that teacher practice held meaning only if it was backed by academic expertise in the area of endodontics, according to no clear criteria or validated instruments. On the other hand, the groundwork was in place for using an epistemological style in endodontics. This provided a basis for the actual improvements, and allowed the tools developed to be dialectically interconnected with teacher experience. A quantitative analysis was not considered, but could be supplemented later to enhance the data analysis in a future study.